小儿高热惊厥236例临床分析_临床医学论文.docVIP

小儿高热惊厥236例临床分析_临床医学论文 小儿高热惊厥236例临床分析_临床医学论文 【摘要】 目的 分析小儿高热惊厥(FC)的临床特点， 探讨治疗和预防复发的措施， 以减少癫疒间、智力低下等后遗症的发生。方法 对236例FC患儿的临床资料进行分析，分析其复发因素、影响转归的因素，并设立发热对照组(185例，发热，无惊厥)，检测2组血钠、钾 、糖水平。结果 FC组首次发作年龄1～3岁178例(75.42%);首次发作体温≥38.5℃183例(77.54%);基础疾病多为急性上呼吸道感染，共186例(78.81%);首发惊厥为全身强直-阵挛性发作202例(85.59%);191例(80.93%)惊厥持续时间lt;15 min。首发年龄lt;6个月或gt;5岁、首发体温lt;38.5℃、FC类型为复杂型FC(CFC)及有惊厥家族史者易复发。首发年龄lt;6个月或gt;5岁、首发体温lt;38.5℃、惊厥持续时间≥15 min、FC类型为CFC、惊厥次数gt;5次、有惊厥家族史及体温正常2周后脑电图仍有异常者易转为癫疒间及合并智力低下。FC组血钠明显低于发热对照组(0.01)， FC组血糖明显高于发热对照组(0.01)。结论 FC首发年龄多为1～3岁，与发热相关;FC多存在低血钠和高血糖。在常规治疗时应注意纠正电解质紊乱和高血糖。其复发与首发年龄、首发体温、FC类型、惊厥家族史有关。FC大多预后较好，少数可发展为癫疒间，要进行积极的干预治疗。 【关键词】 高热惊厥;临床特点;复发;转归;血生化 　　Abstract： Objective To analyze the clinical characteristics of the febrile convulsion (FC) in children and to explore measures to treat and prevent the recurrence so as to reduce the incidence of sequelae, such as epilepsy and mental retardation. Methods 236 cases of children with FC were analyzed as to the recurrent factors, the factors affecting the prognosis and blood biochemical variations. 185 febrile cases without convulsion were designated as the control group. Levels of serum sodium, potassium and blood glucose were tested in both groups. Results Among the 236 FC cases, 178 cases (75.42%) had the first attack at the age from 1 to 3 years; 183 cases (77.54%) had the first attack of fever ≥38.5℃; 186 cases (78.81%) were caused by acute upper respiratory tract infection; 202 cases (85.59%) manifested generalized tonic-clonic seizure in the first attack; 191 cases (80.93%) had the convulsion duration lt;15 min. The recurrent factors included the ages of the first attack lt;6 month or gt;5 years, body temperature at the first attack lt;38.5℃, complicated FC and convulsion family history. The risk factors for the sequelae of epilepsy complicated with mental retardation included the ages of the first attack lt;6 months or gt;5 years, body temperature at the first attack lt;38.5℃, convulsion duration ≥15 min, complicate