轻度胃肠炎伴热性和无热惊厥的对比研究  

Comparative study of febrile and afebrile seizures associated with mild gastroenteritis

作　　者：陈辉[1] 钟建民[1] 陈勇[1] CHEN Hui;ZHONG Jianmin;CHEN Yong(Department of Neurology,Children's Hospital of Jiangxi Province,Nanchang 330006,China.)

机构地区：[1]江西省儿童医院神经内科

出　　处：《江西医药》2019年第8期883-886,911,共5页Jiangxi Medical Journal

摘　　要：目的对比分析轻度胃肠炎伴热性惊厥(FS)和无热惊厥(AFS)的临床特征。方法回顾性分析153例轻度胃肠炎伴惊厥患儿的病例资料。根据惊厥时发热情况,分为AFS组(n=116)和FS组(n=37),前者也称轻度胃肠炎伴良性惊厥(CWG)。结果FS组比AFS组更易合并呼吸道症状(57%vs33%,P<0.05)。FS组惊厥较AFS组更易发生在胃肠炎的第一天(76%vs12%,P<0.05)。在一次病程中,AFS组较FS组更易发生≥2次的惊厥发作(66%vs16%,P<0.05),FS组较AFS组更易发生≥5min的惊厥发作(42%vs9%,P<0.05)。FS组的WBC及CRP均较AFS组高(P<0.05)。AFS组轮状病毒阳性率明显高于FS组(49%vs14%,P<0.05)。AFS组苯巴比妥的有效率高于安定(90%vs50%,P<0.05),而FS组对苯巴比妥及安定有效率均达到100%。结论CWG与轻度胃肠炎并FS具有各自的临床特征,是轻度胃肠炎并惊厥的两种不同的临床实体,临床上需注意鉴别。Objective We analyzed the clinical characteristics of febrile and afebrile seizures associated with mild gastroenteritis. Methods Data of 153 cases of seizures associated with mild gastroenteritis were retrospectively analyzed. According to the fever at the time of seizure,they were classified into afebrile group(AFS)(n=116) and febrile group(FS)(n=37). The former is also known as benign convulsions with mild gastroenteritis(CWG). Results The FS group was more likely to have respiratory symptoms than the AFS group(57% vs 33%,P <0.05). Convulsions were more likely to occur on the first day of gastroenteritis in the FS group than in the AFS group(76% vs 12%,P<0.05). In a course of gastroenteritis,more patients in the AFS group experienced≥2 seizures than in the FS group(66% vs 16%,P<0.05). The FS group was more likely to experience≥5 min seizure than the AFS group(42% vs 9%,P<0.05). WBC and CRP of FS group were higher than AFS group(P<0.05). The positive rate of rotavirus in AFS group was significantly higher than that in FS group(49% vs 14%,P<0.05). The effective rate of phenobarbital in AFS group was higher than that of diazepam(90% vs 50%,P<0.05). However, The effective rate of phenobarbital and diazepam in FS group were 100%. Conclusion CWG and FS with mild gastroenteritis have their own clinical characteristics. They are two different clinical entities in seizures with mild gastroenteritis. In clinical practice, we should pay attention to distinguish the two clinical entities.

关 键 词：轻度胃肠炎 热性惊厥 无热惊厥 

分 类 号：R720.597[医药卫生—急诊医学]