儿童惊厥性癫癎持续状态临床研究

Study on etiology and treatment of convulsive status epilepticus in children

对182例惊厥性癫癎持续状态患儿(包括难治性癫癎持续状态21例、非难治性癫癎持续状态161例)临床资料的回顾分析显示,既往癫癎发作史(54例)、颅内感染(49例)、复杂性热性惊厥(44例)为其主要病因。发作期予氯硝西泮(102例)、地西泮(54例)和咪达唑仑(46例)静脉注射,以及苯巴比妥肌肉注射(36例)、6.5%水合氯醛鼻饲或灌肠(32例)迅速终止发作。尤其是重症病毒性脑炎引起的难治性癫癎持续状态,预后差、病死率高。控制癫癎持续状态以减少脑等重要脏器损伤为治疗原则。

The clinical data of 182 children with convulsive status epilepticus（CSE） were analyzed.There were 21 cases with refractory status epilepticus（RSE） and 161 cases with non-refractory status epilepticus（non-RSE）.Etiological factors mainly included epilepsy in 54 cases,intracranial infection in49 cases,and complex febrile seizure in 44 cases.In the ictal stage,102 cases were treated with clonazepam by intravenous injection,54 cases with diazepam by intravenous injection,46 cases with midazolam by intravenous injection,36 cases with phenobarbital by muscular injection,and 32 cases with6.5%chloral hydrate by nosal feeding or clyster.The etiology of CSE in children is various.Epilepsy,intracranial infection and complex febrile seizure are the main causes.Poor prognosis and high mortality often occur in RSE caused by severe viral encephalitis.So the fundamental principle of treatment is to control CSE quickly and avoid the damage of brain and other important organs.