975例儿科急诊惊厥病因分析

Analysis on the etiology of seizures in a cohort of 975 children admitted to a pediatric emergency department

【摘要】目的探讨儿童惊厥的病因学分布规律及影响因素，提高儿科急诊对惊厥的评估、识别、干预及分流的水平，制定预防、管理及健康宣教的对策和措施。方法回顾性分析2013年10月至2014年10月广州市妇女儿童医疗中心（儿童院区）儿科急诊975例惊厥患儿的临床资料。结果975例惊厥患儿中病因排在前3位的分别是热性惊厥[588例（60．3％）]、癫痫[163例（16．7％）]、轻度胃肠炎并良性婴幼儿惊厥[111例（11．4％）]。按年龄段划分，其中〈1岁惊厥病因以热性惊厥[75例（34．1％）]和癫痫[75例（34．1％）]为主，其次为颅内感染[22例（10．0％）]，1～6岁儿童期惊厥病因以热性惊厥为主[487例（70．3％）]，其次为轻度胃肠炎并良性婴幼儿惊厥[97例（14．0％）]，〉6岁儿童期惊厥病因仍以热性惊厥[26例（41．9％）]和癫痫[20例（32．3％）]为主。结论在儿童惊厥中，热性惊厥是所有年龄段的首位病因，对比以往的研究，癫痫和轻度胃肠炎并良性婴幼儿惊厥的比重增加，颅内感染的比重下降。快速准确地评估病情及识别病因对管理惊厥患儿起关键作用。

Objective To document the etiologies of seizures in children admitted to the pediatric observation unit of an inner city hospital in China. Methods A total of 975 children （ aged 1 month to 18 years old） admitted to the pediatric observation unit of Guangzhou Women and Children＇s Medical Center between October,2013 and October,2014 with seizures were evaluated restrospectively. Results A total of 975 patients were included in this study. The causes of seizures were febrile seizures （588 cases, 60. 3% ）, epilepsy（163 cases, 16.7% ）, and benign infantile convulsions associated with mild gastroenteritis （111 cases,ll. 4% ）. The main causes of seizures for children less than one year old were febrile seizures （75 cases,34. 1% ） and epilepsy（75 cases,34. 1% ） ,following by the intracranial infection（22 cases, 10. 0% ）. Febrile seizures also predominated the causes of seizures among children between one and six years old（ 487 cases, 70.3% ）,whereas benign infantile convulsions associated with mild gastroenteritis accounting for 14.0% （97 cases） of all causes. Meanwhile, the leading causes of seizures for children of six years or older were febrile seizures（26 cases,41.9% ） and epilepsy （20 cases,32. 3% ）. Conclusion Febrile seizures is the leading cause of seizures among children. Contrast to previous studies,the proportions of epilepsy and benign infantile convulsions associated with mild gastroenteritis are increasing,while the proportion of intracranial infection is reducing. Rapid assessment and accurately identifying the etiology play an important role in the management of seizures.