良性惊厥伴轻度胃肠炎患儿临床特征及随访研究

Clinical features and follow-up study of the infants with benign convulsions associated with mild gastroenteritis

目的分析良性惊厥伴轻度胃肠炎(Cw G)患儿临床特征并评估诊治过程中腰椎穿刺检查必要性。方法整理2014年1月至2016年5月收治的32例Cw G患儿临床资料并随访1年,其中11例(34.38%)患儿进行了腰椎穿刺检查,21例(65.62%)患儿未进行腰穿检查。采用Fisher确切概率法与t检验分析临床数据。结果所有进行腰椎穿刺检查患儿脑脊液结果均正常。进行腰穿检查组与未进行腰穿检查组惊厥持续时间、发作次数及复发率差异无统计学意义(P=0.529,0.141,0.534)。46.88%的患儿在病程中出现轻度低钠血症,与血钠正常组相比,低钠血症组患儿年龄更小(15.6±4.27vs.19.23±4.41(月),P=0.025),惊厥时间更长(5.17±7.1 vs.1.09±0.36(min),P=0.043),但两组复发率无显著差异(P=0.212)。结论 Cw G患儿无需进行腰穿检查,低钠血症容易出现在低龄患儿且惊厥时间更长。

Objective To analyze the clinical features of the infants with benign convulsions associated with mild gastroenteritis（ CwG）,and to assess the necessity of lumbar puncture during the diagnosis. Methods This is a retrospective observational study. The clinical data of 32 infants with CwG treated in our department from January2014 to May 2016 were collected and followed up for at least 1 year. 11 infants（ 34. 38%） underwent lumbar puncture,and 21 infants（ 65. 62%） did not undergo this examination. Fisher exact test and t test analysis were used to analyze the clinical data. Results The results of cerebrospinal fluid examination were normal in all infants undergoing lumbar puncture. There was no significant difference in convulsion duration,convulsion frequency,and recurrence rate of convulsion between the two groups during follow-up（ P = 0. 529,0. 141,0. 534）. 46. 88% of the infants had mild hyponatremia during the course of the disease. Compared with the normal serum sodium group,the children in the hyponatremia group were younger（ 15. 6 ± 4. 27 vs. 19. 23 ± 4. 41（ month）,P =0. 025）,and had longer convulsion duration（ 5. 17 ± 7. 1 vs. 1. 09 ± 0. 36（ minute）,P = 0. 043）. However there was no significant difference in the recurrence rate of convulsion between the two groups during follow-up（ P =0. 212）. Conclusion There is no need to do the lumbar puncture in infants with CwG. Hyponatremia is easy to occur in younger infants and associated with a longer duration of convulsions.