122例急性腹泻合并惊厥患儿的临床特点及预后分析

Clinical characteristics and prognosis of 122 child-patients with acute diarrhea complicated with convulsion

目的探讨急性腹泻合并惊厥患儿的临床特点及预后。方法收集笔者所在医院2016年9月—2018年9月122例急性腹泻合并惊厥患儿的临床资料,回顾性分析其临床特点。结果122例急性腹泻合并惊厥患儿多数在3岁以内,占总例数的95.08%。66例患儿在腹泻第1天出现惊厥发作,占总例数的54.10%;28例患儿在腹泻第2天出现惊厥发作,占总例数的22.95%;38例患儿在腹泻第3~5天出现惊厥发作;平均出现在(43.2±33.6)h。惊厥持续时间多在5 min以内;发作次数多数在2次以下。平均住院日(7.0±3.5)d。临床诊断轻度胃肠炎伴良性婴幼儿惊厥(benign infantile convulsions associated with mild gastroenteritis,BICE)52例,占总例数的42.62%;热性惊厥36例,占总例数的29.51%;病毒性脑炎8例,中毒性脑病6例,癫痫20例。其中惊厥持续状态患儿8例,占总例数的6.56%。结论急性腹泻合并惊厥的患儿病因多样,BICE及热性惊厥最为多见,病毒性脑炎及感染性腹泻合并中毒性脑病也需警惕,多次无热惊厥者还需考虑癫痫。

Objective To explore the clinical characteristics and prognosis of child-patients with acute diarrhea complicated with convulsion.Methods The clinical data of 122 child-patients with acute diarrhea and convulsion from September 2016 to September 2018 in author's hospital were enrolled in this study,and their clinical characteristics were analyzed retrospectively.Results The 122 cases of acute diarrhea with convulsion were mostly within 3 years old,accounting for 95.08%of the total.Seizures occurred on the first day of diarrhea in 66 children,accounting for 54.10%of the total number.Eclampsia occurred on the second day of diarrhea in 28 children,accounting for 22.95%of the total number.In 38 cases,convulsions occurred on the 3rd to 5th day after diarrhea.The average onset was(1.8±1.4)days.The duration of convulsion was usually less than 5 minutes.Most of the attacks were less than 2d.The average length of stay was(7.0±3.5)days.Clinical diagnosis of mild gastroenteritis with benign infantile convulsions(benign infantile convulsions associated with mild gastroenteritis,BICE)52 cases,accounting for 42.62%of the total;There were 36 cases of febrile convulsion,accounting for 29.51%of the total.There were 8 cases of viral encephalitis,6 cases of toxic encephalopathy and 20 cases of epilepsy.Among them,8 child-patients with continuous convulsion state,accounting for 6.56%of the total.Conclusion The etiology of acute diarrhea complicated with convulsion is varied in child-patients,BICE and febrile convulsion are the most common,viral encephalitis and infectious diarrhea combined with toxic encephalopathy also need to be vigilant,and epilepsy should be considered in child-patients without febrile convulsion for many times.