儿童发热期间诱发高热惊厥的风险因素及预后护理策略的制定  

Risk factors for febrile seizures during childhood fever and development of prognostic nursing strategies

作　　者：陈鹤 韩玲芝 杨琪 彭维 邹利霞 CHEN He;HAN Lingzhi;YANG Qi;PENG Wei;ZOU Lixia(Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中西医结合护理(中英文)》2025年第2期153-156,共4页Journal of Clinical Nursing in Practice

摘　　要：目的分析儿童发热期间诱发高热惊厥的风险因素,并制定应对策略。方法选取2020年1月至2023年1月期间在华中科技大学同济医学院附属同济医院就诊的16000例发热儿童,分析其病例资料和护理资料,记录患儿在发热期间发生高热惊厥的情况,并对诱发高热惊厥的风险因素进行单因素和多因素分析,同时根据相关风险因素绘制受试者工作特征曲线(ROC)。结果16000例发热患儿中,发生高热惊厥80例,发生率为0.50%。单因素分析示,高热惊厥的发生与患儿年龄、体温、家族史、上呼吸道感染、早产、血钠、血钙水平及中性粒细胞与淋巴细胞比值均有关(P均<0.05);多因素分析示,年龄、体温、上呼吸道感染、血钠和血钙水平均是患儿诱发高热惊厥的独立危险因素(P均<0.05)。绘制ROC曲线发现对诱发高热惊厥的预测价值AUC为0.832(95%CI:0.783~0.901),特异性为0.742、敏感度为0.586。结论儿童在发热期间发生高热惊厥与年龄、体温、上呼吸道感染、血钠和血钙水平均有关,临床可采取快速降温、纠正低血钠及低血钙等针对性措施,尤其是低龄儿童,以预防高热惊厥的发生。Objective To analyze the risk factors for febrile seizures during fever in children and to develop corresponding coping strategies.Methods A total of 16000 febrile children who visited Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2020 to January 2023 were selected.Their case and nursing data were analyzed to record the occurrence of febrile seizures during fever.Univariate and multivariate analyses were conducted on the risk factors inducing febrile seizures,and receiver operator characteristic(ROC)curves were plotted based on relevant risk factors.Results Among 16000 febrile children,80 cases developed febrile seizures,with an incidence rate of 5.00%.Univariate analysis showed that the occurrence of febrile seizures was associated with age,body temperature,family history,upper respiratory tract infection,premature birth,serum sodium,serum calcium,and neutrophil to lymphocyte ratio(P<0.05).Multivariate analysis showed that age,body temperature,upper respiratory tract infection,serum sodium,and serum calcium were all independent risk factors for febrile seizures in children(P<0.05).By plotting the ROC curve,it was found that the AUC value for inducing febrile seizures was 0.832(95%CI:0.783~0.901),with a specificity of 0.742 and a sensitivity of 0.586.Conclusion The occurrence of febrile seizures in childhood fever is associated with age,body temperature,upper respiratory tract infection,serum sodium,and serum calcium.Targeted measures such as rapid cooling,correction of hyponatremia and hypocalcemia can be taken in clinical practice,especially in young children,to help prevent the occurrence of febrile seizures.

关 键 词：发热 高热惊厥 风险因素 护理策略 

分 类 号：R473.72[医药卫生—护理学]