轻度胃肠炎伴良性婴幼儿惊厥的抗惊厥治疗分析

摘要

Objective To improve the recognition and anticonvulsion efficiency of benign infantile convulsions associated with mild gastroenteritis (BICE),48 patient's clinical characteristics,anticonvulsants and prognosis were analyzed. Methods The medical records and followed-up results of 48 patients diagnosed with BICE between January 2013 to December 2016 in the Pediatrics ward of Taizhou Municiple Hospital were reviewed and analyzed. Results During the acute phase,diazepam(0.3～0.5mg/kg intravenous or enema treatment)and phenobarbital(10mg/kg intramuscular or intravenous)as first or second line treatment were effective in 11.11％(1/9)and 83.33％(20/24)of cases respectively.3 cases given midazolam(0.1 ～ 0.2mg/kg intramuscular or intravenous)and 2 cases given 10％ chloral hydrate(0.5 ml/kg enema treatment)were all controlled. During 3 ～12 months follow-up,one case had a febril convulsion,while 44 cases had no seizure.38 cases showed normal electroencephalogram post-discharge and 45 cases showed normal psychomotor development. Conclusions BICE occurs mostly in infants and young children. In the acute phase,phenobarbital is more effective than diazepam in controlling seizure,and the difference was statistically significant(P<0.05). Midazolam and 10％ chloral hydrate were effective too.For a good prognosis,it is unnecessary to administrate long-term anticonvulsants.%目的 通过对48例轻度胃肠炎伴良性婴幼儿惊厥(BICE)的临床特点、抗惊厥治疗及预后的分析,提高对该病的认识及抗惊厥治疗的有效率.方法 分析2013年1月至2016年12月48例符合BICE的患儿的临床特点、抗惊厥治疗及出院后随访结果.结果 惊厥急性发作期,9例给予地西泮0.3～0.5mg/kg静脉推注或灌肠治疗,1例惊厥控制,有效率11.11％.24例给予苯巴比妥10mg/kg肌肉或静脉注射治疗,20例惊厥控制,有效率83.33％,3例给予咪达唑仑0.1～0.2mg/kg肌肉或静脉注射,2例给予10％水合氯醛0.5ml/kg灌肠,惊厥均控制.45例随访3～12个月,1例8个月后再发热性惊厥,44例无惊厥发作.38例出院后脑电图检查正常.45例智力运动发育正常.结论 BICE大多发生在婴幼儿.在惊厥急性发作期,苯巴比妥控制惊厥比地西泮更有效.咪达唑仑和10％水合氯醛对惊厥有效.BICE预后良好,不需要长期抗癫痫治疗.