常州市小儿热性惊厥流行病学特点及继发癫痫的危险因素分析

摘要

目的 探讨常州市小儿热性惊厥流行病学特点及继发癫痫的危险因素.方法 回顾性分析100例热性惊厥患儿的临床资料,按照是否继发癫痫分为癫痫组与非癫痫组,总结小儿热性惊厥流行病学特点,分析继发癫痫的危险因素.结果 2013年—2015年常州市小儿热性惊厥发病率呈逐渐上升趋势.本组热性惊厥患儿以男性多见,发病年龄以6个月—3岁居多,发病季节以冬、秋为主,原发病多为上呼吸道感染,脑电图异常所占比例较高,首次惊厥发作类型以全身性多见,体温多在38 .9 ℃以内,大部分首次惊厥前发热时间均＜24 h ,首次惊厥次数为≤3次居多,惊厥持续时间＜20 min所占比例较高,分型以复杂型热性惊厥为主,部分患儿有围生期异常情况.本组随访继发癫痫8例,癫痫组年龄显著小于非癫痫组(P＜0 .01) ,癫痫组热性惊厥家族史、脑电图异常、复杂型热性惊厥患儿、惊厥次数显著多于非癫痫组(P＜0 .05或0 .01) ,惊厥持续时间显著长于非癫痫组(P＜0 .01).结论 惊厥次数＞3次、脑电图异常、复杂型热性惊厥均为热性惊厥患儿继发癫痫的独立危险因素,积极控制上述危险因素并予以预防性治疗,可降低癫痫发生风险.%Objective To explore the epidemiological characteristics of febrile seizures in children in Chan-gzhou and the risk factors for epilepsy.Methods The clinical data of 100 children with febrile seizures were retrospectively analyzed.They were divided into epilepsy group and non-epileptic group according to the occurrence of conversion to epilepsy.Summarize the epidemiological characteristics of febrile seizures in children and analyze the risk factors for conversion to epilepsy.Results From 2013 to 2015 ,the inci-dence of FC in children in Changzhou City showed a gradually increasing trend.In this study ,most of the children with FC were boys ,and the age of onset mainly was 6 months-3 years old.The main onset sea-sons were winter and autumn ,and the main primary disease was upper respiratory tract infection.The proportion of EEG abnormalities was high ,and the first seizure type was general type.The body tempera-ture mainly was within 38.9 degrees ,and the fever time before initial convulsion mainly was shorter than 24h.The times of initial convulsion mainly was ≤3 times ,and the proportion of duration of convulsion ＜20 min was relatively higher.Complex febrile convulsion was the main type ,and some children had peri-natal abnormalities.There were 8 cases with secondary epilepsy during follow-up period ,the age of pa-tients in the epilepsy group was significantly smaller than that in the non-epileptic group (P＜0.01).The proportions of family history of febrile seizures ,abnormal EEG ,children with complex febrile seizures , and number of seizures in the epilepsy group was significantly high than those in the non-epileptic group (P＜0.05 or 0.01).The duration of convulsions was significantly longer than that in the non-epi-leptic group (P＜0.01).Conclusion The number of convulsions ＞ 3 ,EEG abnormalities ,complex febrile seizures are independent risk factors for conversion of epilepsy in children with febrile seizures.Ac-tive control of the above risk factors and preventive treatment can reduce the risk of epilepsy.