高热惊厥小儿的临床特征及预后分析

Clinical characteristics and prognosis of children with hyperpyretic convulsion

  • 摘要:
      目的  分析高热惊厥小儿的临床特征及预后。
      方法  收集本院收治的241例高热惊厥患儿的临床资料,并对患儿的临床特征进行分析,包括年龄分布、性别比、发病季节、惊厥次数、原发疾病、家族史、脑电图特征、头颅CT、治疗方法等。对所有患儿进行为期2年的随访,根据随访中是否再次发生高热惊厥分为复发组和对照组,其中复发组74例,对照组167例。对复发组的临床特征进行分析,包括复发次数、复发时间等。对小儿高热惊厥的复发因素进行分析,包括患儿首发高热惊厥时的年龄、体温、持续时间、类型、家族史等。
      结果  241例高热惊厥小儿中, 6个月~3岁者206例(85.48%)占比最高; 单纯性惊厥149例(61.83%), 复杂性惊厥92例(38.17%); 家族惊厥史117例(48.55%), 癫痫遗传史11例(4.56%); 原发疾病主要为上呼吸道感染146例(60.58%)。随访中, 228例(94.61%)高热惊厥小儿预后良好, 7例(2.90%)患儿转为癫痫, 3例(1.24%)患儿发生脑损伤, 74例(30.71%)复发。年龄≤3岁、复杂性惊厥、有惊厥家族史、有癫痫遗传史、首发时惊厥发生次数≥2次、首次发作体温≥39 ℃均为导致高热惊厥患者复发的危险因素。
      结论  高热惊厥小儿一般预后较好,对于首次发生高热惊厥后复发风险较高的患儿,应及时进行预防性治疗,同时对家长进行相关的健康教育及急救知识普及,以降低不良预后发生率。

     

    Abstract:
      Objective  To analyze the clinical features and prognosis of children with hyperpyretic convulsion.
      Methods  A total of 241 children with hyperpyretic convulsion admitted to our hospital were enrolled in this study. The clinical characteristics of the children including age distribution, gender ratio, onset seasons, times of convulsions, primary disease, family history, electroencephalogram characteristics, head CT, and treatment methods were analyzed. All patients were followed up for 2 years. According to whether recurrence of hyperpyretic convulsion during follow-up, the patients were divided into recurrent group(n=74) and control group(n=167). The clinical features including the relapse frequency and time of the recurrent group were analyzed. The recurrence factors of hyperpyretic convulsion including age, body temperature, duration, attack types, and family history of the first onset of hyperpyretic convulsion of children were analyzed.
      Results  Out of 241 children with hyperpyretic convulsion, 206 cases (85.48%) aged 6 months to 3 years accounted for the highest proportion. There were 149 cases (61.83%) with simple convulsions and 92 (38.17%) with complicated convulsions, 117 cases with a family history of convulsions (48.55%) and 11 with a family history of epilepsy (4.56%). The primary disease was mainly upper respiratory tract infections in 146 cases (60.58%). During follow-up, 228 (94.61%) children with hyperpyretic convulsion had a good prognosis, 7 (2.90%) transformed to epilepsy, 3 (1.24%) had brain injury, and 74 (30.71%) had recurrence of convulsion. Age ≤ 3 years old, complex convulsion, family history of convulsions and epilepsy, the number of first onset of convulsion ≥ 2 times, and the first episode temperature ≥ 39 ℃ were risk factors for recurrence of hyperpyretic convulsion.
      Conclusion  Generally, children with hyperpyretic convulsion have a good prognosis. For children with high risk of recurrence after first episode of hyperpyretic convulsion, preventive treatment should be carried out timely, and relevant health education as well as first aid knowledge should be popularized for parents to reduce poor prognosis rate.

     

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