33例儿童癫痫持续状态的临床特点及预后影响因素分析

Clinical characteristics and prognostic factors of 33 children with status epilepticus

目的分析儿童癫痫持续状态(Status epilepticus,SE)的临床特点及预后影响因素。方法收集2014年1月—2021年6月山东大学附属济南市中心医院收治的33例SE患儿的临床资料,分析其临床特点,根据格拉斯哥预后评分量表将患儿分为预后良好组(n=20)和预后不良组(n=13),比较两组患儿的首次发作年龄、发作持续时间、发作类型、SE分型、脑电图、头部影像学、病因等情况,分析SE预后的影响因素。结果首次发作年龄中0~6岁占75.7%,发作类型分类中惊厥性癫痫持续状态29例占87.9%。两组首次发作年龄、发作持续时间、脑电图、精神发育迟滞史、病因等比较的差异具有统计学意义(P<0.05);Logistic回归分析发现患儿首次发作年龄、发作持续时间、精神发育迟滞史、脑电图是影响SE预后的独立因素。结论首次发作年龄≤6岁者是儿童SE的高发期,大部分患儿为症状性SE且有明显诱因,惊厥性癫痫持续状态为儿童SE的主要发作类型。患儿首次发病年龄、癫痫持续时间、精神迟滞史、脑电图影响SE的预后。

Purpose To analyze the clinical characteristicsand prognostic factors of Status epilepticus(SE)in children.Methods The clinical data of 33 children with SE treated in Jinan Central Hospital Affiliated of Shandong University from January 2014 to June 2021 were collected,and their clinical characteristics were analyzed.Then,according to Glasgow prognosis scale,the children were divided into good prognosis group(n=20)and poor prognosis group(n=13).The age of first attack,duration of attack,type of attack and SE classification,EEG,cranial imaging and etiology were used to analyze the influencing factors of SE prognosis.Results 75.7%were 0~6 years old in the age of first attack,and 29 cases of convulsive status epilepticus accounted for 87.9%in the classification of seizure types.There were significant differences in age of first attack,duration of attack,EEG,history of mental retardation and etiology between the two groups(P<0.05);Logistic regression analysis showed that the age of first attack,duration of attack,history of mental retardation and EEG were independent factors affecting the prognosis.Conclusion Low age,especially≤6 years old,is the high incidence of SE in children at first attack.Most children are symptomatic and have obvious incentives.Convulsive SE is the main type of SE in children.The age of first onset,duration of epilepsy,history of mental retardation,and EEG can affect the prognosis of SE.