北京市某儿童医院急诊儿童惊厥病例回顾性分析  

Retrospective analysis of pediatric convulsion cases in the emergency department of a children's hospital in Beijing

作　　者：段朱岩 曲艳凝 刘军廷[2] 王珺 王惠[1] 郭琳瑛[1] 曲东[4] 任晓旭[4] Duan Zhuyan;Qu Yanning;Liu Junting;Wang Jun;Wang Hui;Guo Linying;Qu Dong;Ren Xiaoxu(Department of Emergency,Capital Institute of Pediatrics'Children's Hospital,Beijing 100020,China;Child Health Big Data Research Center,Capital Institute of Pediatrics,Beijing 100020,China;Department of Neurology,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China;Department of Critical Care Medicine,Capital Institute of Pediatrics'Children's Hospital,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院急诊科,北京100020 [2]首都儿科研究所儿童健康大数据研究中心,北京100020 [3]首都医科大学附属北京儿童医院神经内科,100045 [4]首都儿科研究所附属儿童医院重症医学科,北京100020

出　　处：《中国小儿急救医学》2024年第10期777-782,共6页Chinese Pediatric Emergency Medicine

摘　　要：目的全面分析急诊儿童惊厥的临床特征、病因分类、治疗方式及转归, 为儿童惊厥的诊断和治疗提供依据, 优化儿童惊厥急诊管理。方法回顾性分析2016年1月1日至2020年12月31日, 首都儿科研究所附属儿童医院急诊科18 217例惊厥患儿的临床资料。结果 18 217例儿童因惊厥入急诊, 占全部急诊就诊患儿的2.3%。男性占58.7%, 女性占41.3%, 平均年龄为(2.00±0.03)岁, 主要年龄段为1~3岁(54.2%)。全面性惊厥为主要类型(82.3%), 局灶性发作占17.7%, 发作大多持续不超过5 min(82.4%), 约55.2%患儿能自行缓解。热性惊厥(69.2%)为首要病因, 其次是轻度胃肠炎伴婴幼儿良性惊厥(11.7%)和癫痫(10.5%)。在治疗上, 55.2%患儿未经药物治疗自行恢复。按"三区四级"分诊, 红区患儿中抗惊厥药物使用率达93.1%, 需联合治疗的占21.6%。治疗后48.2%患儿离院, 92.2%病情改善或痊愈, 病死率极低, 仅0.03%。结论热性惊厥是急诊儿童惊厥的主要病因, 高效分诊系统对提升治疗响应有重要作用, 不同分区的诊疗及转归各异, 为优化急诊处理提供了重要参考。Objective To comprehensively analyze the clinical characteristics,classification of causes,treatment methods,and outcomes of pediatric convulsions in the emergency department,providing a scientific basis for the diagnosis and treatment of pediatric convulsions and optimizing emergency management for these cases.Methods The clinical data of 18217 children with convulsions in the emergency department of Capital Institute of Pediatrics'Children's Hospital from January 1,2016 to December 31,2020 were retrospectively analyzed.Results A total of 18217 children were admitted to the emergency department due to convulsions,accounting for 2.3%of all visits.Among them,58.7%cases were male and 41.3%cases were female,with an average age of(2.00±0.03)years.The main age was 1 to 3 years old(54.2%).Generalized convulsions were the primary type(82.3%),with focal seizures accounting for 17.7%.Most convulsions lasted less than 5 minutes(82.4%),and approximately 55.2%of the patients could self-resolve.Febrile convulsions were the primary cause(69.2%),followed by benign convulsions with mild gastroenteritis(11.7%)and epilepsy(10.5%).Regarding treatment,54.0%of the children recovered without medication.In the triage system of"three zones and four levels,"the usage rate of anticonvulsants in the red zone was 93.1%,with 21.6%requiring combined treatment.After treatment,48.2%of the children returned home,92.2%showed improvement or recovery,and the mortality rate was extremely low at only 0.03%.Conclusion Febrile convulsions are the main cause of pediatric convulsions in the emergency department,and an efficient triage system play an important role in improving treatment response.Different treatment zones and outcomes vary,providing important reference for optimizing emergency management.

关 键 词：惊厥 急诊 分诊系统 病因 儿童 

分 类 号：R720.597[医药卫生—急诊医学]