轻度胃肠炎伴婴幼儿良性惊厥在婴幼儿急性腹泻伴惊厥疾病谱中的地位及意义

Status and Significance of Benign Infantile Convulsion with Mild Gastroenteritis in the Spectrum of Infantile Convulsion with Acute Diarrhea

目的探讨轻度胃肠炎伴婴幼儿良性惊厥(BICE)在婴幼儿急性腹泻伴惊厥疾病谱中的地位及意义。方法对2009-2011年收治的急性腹泻并有惊厥症状患儿的住院资料进行回顾性分析。结果 184例急性腹泻伴惊厥的病例中,轻度胃肠炎伴婴幼儿良性惊厥58例、热性惊厥49例、癫癎43例、病毒性脑炎19例、低钠性脑病6例、高钠性脑病5例、中毒性脑病2例、低钙惊厥2例。BICE患儿年龄为(17.47±7.90)个月,全身症状轻,脱水轻或无,惊厥多呈全面性强直或强直阵挛发作,发作持续时间短,多发生在病程前2 d;轮状病毒阳性率为65.52%;血常规、生化、脑脊液、CT/MRI、脑电图等无明显异常。BICE患儿入院后予补液治疗,在首次惊厥后给予肌注苯巴比妥,住院过程惊厥再发者立即静脉注射地西泮,均住院2～5 d治愈出院。结论 BICE为婴幼儿急性腹泻伴惊厥中的常见疾病,临床应以对症治疗为主,应避免不必要的检查和过度药物治疗。

Objective To explore the status and significance of benign infantile convulsion with mild gastroenteritis（BICE） in the spectrum of infantile convulsion with acute diarrhea. Methods One hundred and eighty-four cases of convulsion with acute diarrhea treated in our hospital from 2009 to 2011 were analyzed retrospectively. Results Among the 184 cases of convulsion with acute diarrhea,there were 58 BICE,49 febrile seizures,43 epilepsy,19 viral encephalitis,6 hyponatremic encephalopathy,5 hypernatremic encephalopathy,2 toxic encephalopathy and 2 hypocalcemic seizures.The average age of children with BICE was（17.47±7.90） months.The symptoms were generally mild with little or no signs of dehydration.The seizure occurred mostly during the first two days of the illness and was brief in a tetanic or clonic form.Positive rotavirus antigens were detected in 65.52%.There were no abnormal findings in the routine blood test,blood bioche-mistry,cerebrospinal fluid,cerebral computerized tomography/magnetic resonance imaging and electroencephalogram examinations.After hospitalization,the children were given fluids intravenously.Sodium phenobarbital was administered after the first convulsion and if seizures recurred,diazepam was given intravenously.All children were fully recovered in 2 to 5 days after hospitalization. Conclusions BICE occurs frequently in the infantile convulsion with acute diarrhea and symptomatic treatment is sufficient in patient care.Thus,unnecessary medical tests and excessive treatment should be avoided.