310例惊厥患儿的病因及临床特征分析

Analysis of etiology and clinical characteristics of 310 children with convulsion

目的分析310例惊厥患儿的病因及临床特征,以为临床诊治提供参考。方法选取2019年1月至2020年12月于福建省立金山医院就诊的310例惊厥患儿作为研究对象,统计并分析患儿惊厥的病因和临床特征。结果310例惊厥患儿中,男、女占比分别为63.2%、36.8%;>1~3岁患儿最多,占64.8%;最常见病因为热性惊厥,占78.1%;其次为颅内感染(12.9%)和癫痫(5.5%);28 d至6岁患儿病因以热性惊厥最常见,>6~14岁患儿病因以颅内感染最常见。热性惊厥患儿均有发热(100.0%),男患儿最多(64.5%),多无既往惊厥史(87.2%),多为单次(93.8%)全面性惊厥发作(96.7%),惊厥持续时间多<15 min(93.0%),颅脑特殊检查异常情况较少;颅内感染患儿均有发热(100.0%),男患儿较多(62.5%),多无既往惊厥史(95.0%),多为单次(70.0%)全面性惊厥发作(97.5%),惊厥持续时间多<15 min(67.5%),颅脑特殊检查异常占比较高(87.5%)。癫痫患儿男女占比相当,多数无发热(94.1%),既往均有惊厥病史(100.0%),均为多次(100.0%)并呈全面性惊厥发作(76.5%),颅脑特殊检查无异常占比58.8%,颅脑特殊检查异常占比41.2%;轻度胃肠炎伴婴幼儿惊厥患儿男女占比相当,多数无发热(77.8%),均无既往惊厥病史(100.0%),多为单次(88.9%)并呈全面性惊厥发作(100.0%),颅脑特殊检查均未发现异常(100.0%)。结论引起儿童惊厥的病因复杂,应根据病史、体格检查和辅助检查尽早做出病因诊断,以及时治疗改善预后。

Objective To analyze the etiology and clinical characteristics of 310 children with convulsions in order to provide reference for clinical diagnosis and treatment.Methods 310 children with convulsions treated in Fujian Provincial Hospital from January of 2019 to December of 2020 were selected as the study subjects,and the etiology and clinical characteristics of convulsion were statistically analyzed.Results Among 310 children with convulsion,males and females were accounted for 63.2%and 36.8%,respectively;>1-3 years old children with the most,accounting for 64.8%;the most common disease was febrile convulsion,accounting for 78.1%,followed by intracranial infection(12.9%)and epilepsy(5.5%);febrile convulsion was the most common cause in children aged 28 d to 6 years,and intracranial infection was the most common cause in children aged>6-14 years.All the children with febrile convulsion had fever(100.0%),most of them were male(64.5%),most had no previous history of convulsion(87.2%),most had a single convulsion(93.8%),most had a general convulsion(96.7%),the most duration of convulsion<15 min(93.0%),and the abnormalities of special brain examination were less.All of the children with intracranial infection had fever(100.0%),most of them were male(62.5%),most of them had no previous history of convulsion(95.0%),most of them were single(70.0%)general convulsion(97.5%),the most duration of convulsion<15 min(67.5%),and the proportion of abnormal cranial examination was higher(87.5%).The proportion of male and female children with epilepsy was equal,most of them had no fever(94.1%),all of them had a history of convulsion in the past(100.0%),all of them had multiple convulsions(100.0%)and presented a general convulsion attack(76.5%),58.8%of them had no abnormal brain special examination,41.2%of them had abnormal brain special examination.The proportion of male and female children with mild gastroenteritis and infantile convulsion was equal,most of them had no fever(77.8%),no previous history of convulsion(100.0%),most of them were single(88.9%)and presented with general convulsion attack(100.0%),and no abnormalities were found in special cranial examination(100.0%).Conclusion The etiology of convulsions in children are complex,and the etiology should be diagnosed as early as possible according to the history,physical examination and auxiliary examination,and timely treatment can improve the prognosis.