以惊厥为主诉的住院儿童惊厥病因临床分析  

Clinical analysis of the causes of convulsion in hospitalized children with convulsion as the main complaint

作　　者：赵阳艳 曹兴丽 张宇升 单奔 ZHAO Yangyan;CAO Xingli;ZHANG Yusheng;SHAN Ben(Department of Pediatrics,Langao County Hospital,Ankang,Shaanxi,725400,China;Department of Pediatrics,Huai'an Second People's Hospital/the Affiliated Huai'an Hospital of Xuzhou Medical University,Huai'an,Jiangsu,223002,China;Department of Radiology,Huai'an Fifth People's Hospital/Affiliated Huai'an Hospital of Yangzhou University,Huai'an,Jiangsu,223300,China)

机构地区：[1]岚皋县医院儿科,陕西安康725400 [2]淮安市第二人民医院/徐州医科大学附属淮安医院儿科,江苏淮安223002 [3]淮安市第五人民医院/扬州大学附属淮安医院放射科,江苏淮安223300

出　　处：《当代医学》2023年第15期137-141,共5页Contemporary Medicine

摘　　要：目的分析以惊厥为主诉的住院儿童惊厥病因。方法回顾性分析2020年4月至2022年3月淮安市第二人民医院收治的165例以惊厥为主诉的住院患儿的临床资料。统计以惊厥为主诉患儿占比、惊厥发作病因[热性惊厥(单纯性热性惊厥、复杂性热性惊厥)、癫痫或癫痫发作、轻度胃肠炎伴婴幼儿良性惊厥、中枢神经系统感染、脑梗死、低血糖及病因未明确]、惊厥时发热患儿、不同惊厥发作病因患儿2次及以上惊厥发生率、无热惊厥患儿与有热惊厥患儿2次及以上惊厥发生率及轻度胃肠炎伴婴幼儿良性惊厥发生时间。结果2020年4月至2022年3月淮安市第二人民医院儿科共收治患儿2617例,其中以惊厥为主诉的住院患儿165例,占住院患儿的6.3%。热性惊厥占61.8%,其中单纯性热性惊厥占77.5%,复杂性热性惊厥占22.5%;癫痫或癫痫发作占22.4%,其中癫痫31例,癫痫发作6例;轻度胃肠炎伴婴幼儿良性惊厥占7.3%;中枢神经系统感染占1.8%,其中病毒性脑炎2例,化脓性脑膜炎1例;低血糖占比0.6%;脑梗死占比0.6%;出院诊断病因未明确占比5.5%。惊厥时发热患儿106例,其中热性惊厥102例、中枢神经系统感染3例、癫痫1例(住院时惊厥共2次,伴有发热)。其中热性惊厥患儿出现2次及以上惊厥者13例,再次发生惊厥时体温均高于首次惊厥时体温,且体温均≥39.0℃,其中>40℃者4例,39.5~40℃者5例,39.0~39.5℃者4例。不同惊厥发作病因患儿2次及以上惊厥发生率比较差异有统计学意义(P<0.05);癫痫或癫痫发作2次及以上惊厥发生率高于热性惊厥,轻度胃肠炎伴婴幼儿良性惊厥2次及以上惊厥发生率高于热性惊厥,差异有统计学意义(P<0.05)。无热惊厥患儿2次及以上惊厥发生率高于有热惊厥患儿,差异有统计学意义(P<0.05)。轻度胃肠炎伴婴幼儿良性惊厥发生2次及以上惊厥者7例,惊厥均发生于病程的72 h内。结论患儿发生惊厥的主Objective To investigate the causes of convulsion in hospitalized children with convulsion as the main complaint.Methods The clinical data of 165 hospitalized children with convulsion as the main complaint admitted to Huai'an Second People's Hospital from April 2020 to March 2022 were retrospectively analyzed.The proportion of children with convulsions as the chief complaint,the etiology of convulsions(febrile convulsions[simple febrile convulsions,complex febrile convulsions],epilepsy or epileptic seizures,mild gastroenteritis with benign convulsions in infants and young children,central nervous system infection,cerebral infarction,hypoglycemia and unclear etiology),children with fever during convulsions,children with different causes of convulsions.The incidence of 2 or more convulsions,the incidence of 2 or more convulsions in children with no febrile convulsions and children with febrile convulsions,and the time of occurrence of benign convulsions in infants and young children with mild gastroenteritis.Results From April 2020 to March 2022,a total of 2617 children were admitted to the Department of Pediatrics of Huai'an Second People's Hospital,including 165 hospitalized children with convulsions as the main complaint,accounting for 6.3%of hospitalized children.Among 165 hospitalized children,febrile seizures accounted for 61.8%;simple febrile seizures accounted for 77.5%,complex febrile seizures accounted for 22.5%;Epilepsy or epileptic seizures accounted for 22.4%,including 31 cases of epilepsy and 6 cases of epileptic seizures;mild gastroenteritis with benign infantile convulsions accounted for 7.3%;central nervous system infection accounted for 1.8%,including 2 cases of viral encephalitis and 1 case of purulent meningitis;hypoglycemia accounted for 0.6%;cerebral infarction accounted for 0.6%;the proportion of unclear causes of discharge diagnosis was 5.5%.There were 106 children with fever during convulsion,including 102 cases of febrile convulsion,3 cases of central nervous system infection,and 1 case of

关 键 词：惊厥 住院儿童 病因 

分 类 号：R720.597[医药卫生—急诊医学]