轻度胃肠炎伴婴幼儿良性惊厥229例临床分析

Benign infantile convulsions with mild gastroenteritis:clinical analysis of 229 cases

目的：探讨轻度胃肠炎伴婴幼儿良性惊厥的临床特点。方法对229例符合轻度胃肠炎伴婴幼儿良性惊厥的3岁内患儿的临床资料、辅助检查结果及随访资料进行回顾性分析。结果轻度胃肠炎伴婴幼儿良性惊厥在性别方面无统计学差异（χ^2＝2．268，P＞0．05）；24月龄内发病204例（89．1％），为高发，具有统计学意义（χ^2＝6．75，P＜0．05）；10～12月份发病89例（38．9％），1～3月份发病68例（29．7％），发病季节以冬春季为主，差异具有统计学意义（χ^2＝6．38，P＜0．05）；158例（69％）有呕吐，其中93例（40．6％）伴有腹泻，71例（31．0％）仅有呕吐无明显腹泻；肠道病毒检测阳性32例（13．90％），呼吸道病毒检出阳性53例（27．5％）；血糖、血电解质均正常，脑脊液常规、生物化学检查正常，脑脊液细菌涂片和培养均为阴性；头颅CT／MRI检查、脑电图检查，均未见异常；随访中有12例（5．2％）出现复发，10例（4．4％）出现热性惊厥，6例（2．6％）诊断为癫痫。结论轻度胃肠炎伴婴幼儿良性惊厥大多数病例预后良好，少数病例有向热性惊厥及癫痫转化的可能，应动态随访12个月。

Objective To discuss the clinical features of benign infantile convulsions associated with mild gastroenteritis.Methods Retrospective analysis was conducted on clinical data, auxiliary examination results and follow-up data of 229 children under 3 years old showing benign convulsions associated with mild gastroenteritis.Results There was no statistical significance in incidence of benign infantile convulsions associated with mild gastroenteritis between genders （χ^2 =2.268,P〉0.05）.Among children under 24 months old there were 204 cases （89.1%） , and the incidence was high （χ^2 =6.75,P〈0.05） .The onset of 89 cases （38.9%） was during October to December and 68 cases （ 29.7%） during January to March.Winter and spring were the frequent onset seasons with statistical significance （χ^2 =6.38,P〈0.05）.Vomiting occurred in 158 cases （69%）, including 93 cases （40.6%） companied with diarrhea and 71 cases （31.0%） without obvious signs of diarrhea.Enterovirus was positive in 32 cases （13.90%） and respiratory virus was positive in 53 cases （27.5%）.For all cases, blood sugar and blood electrolyte were normal, cerebrospinal fluid （CSF） kept normal, and no abnormality was found in biochemical examination.CSF culture was negative.No abnormalities were found in brain CT/MRI scan and EEG examination.In the follow-up period, there were 12 recurrent cases （5.2%） and 10 cases （4.4%） of febrile convulsion.Six cases （2.6%） were diagnosed as epilepsy.Conclusion Most cases of benign infantile convulsions associated with mild gastroenteritis obtain good prognosis.A few of them might develop into febrile convulsion or epilepsy, so dynamic follow-up lasting 12 months is necessary.