儿童重症监护室电惊厥发作脑电图临床特点分析  

Clinical analysis and Electroencephalogram of electrographic seizure in pediatric ICU patients

作　　者：胡巧[1] 兰兴会[1] 陈锦[1] Hu Qiao;Lan Xinghui;Chen Jin(Department of Neurology, Children's Hospital of Chongqing Medical University,Chongqing Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China)

机构地区：[1]重庆医科大学附属儿童医院神经内科、儿童发育疾病研究教育部重点实验室、儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,重庆400014

出　　处：《医药前沿》2019年第7期29-30,共2页Journal of Frontiers of Medicine

摘　　要：目的:分析在儿童重症监护室(PICU)中电惊厥发作的脑电图(EEG)临床特点,提高对电惊厥发作的早期识别能力.方法:分析2015年8月至2018年11月入住重庆医科大学附属儿童医院PICU的电惊厥发作患儿95例,其EEG及临床特征.结果:EEG示电惊厥发作占同期EEG的12.1%(150/1238),其中63%为无临床发作,39%为癲痫持续状态,且多为非惊厥性癲痫持续状态;导致电惊厥发作飽前三位疾病为:急性中枢感染性疾病(32例)、缺氧缺血性脑病(16例)及癲痫相关疾病(13例);在完善脑电监测之前,38%以上的患儿有至少一次的临床发作,且37例为惊厥性癲痫持续状态.结论:电惊厥发作患儿中临床下放电、尤其非惊厥性癫痫持续状态在儿童重症监护中并不少见,对重症患儿应进行长程视频甚至连续脑电监测,以早期发现并积极治疗电惊厥发作,改善患儿预后.Objective To investigate the clinical characteristics and electroencephalogram of electrographic seizure in pediatric ICU patients and improve early and accurate clinical diagnosis.Methods The clinical and EEG characteristics in 95 patients with electrographic seizures in pediatric ICU patients were analyzed.Results Electrographic seizures occurred in 150 of 1238 subjects(12.1%).Electrographic seizures were exclusively subclinical in 59 of 95 subjects(63%),of which 37 subjects(39%] had electrographic status seizures.The top three diseases leading to electrographic seizures are: acute CNS infection(32],hypoxic-ischemic encephalopathy(16),epilepsy-related(13];Before the EEG monitoring, more than 90% of the children had at least one clinical seizure,and 48 (51%) of the children had status seizures. Conclusion Electrographic seizures,especially non-convulsive electrographic seizures were common in pediatric ICU.Long-term video or continuous EEG monitoring should be performed for pediatric ICU patients to detect electrographic seizures and improve the prognosis.

关 键 词：电惊厥发作 PICU 脑电图 

分 类 号：R729[医药卫生—儿科]