婴幼儿腹泻合并惊厥的26例临床分析

目的：探讨婴幼儿腹泻合并惊厥的发病原因以及有效的治疗方法。方法回顾性分析26例腹泻合并惊厥患儿的临床资料。结果26例腹泻合并惊厥患儿发病因素主要有：电解质紊乱34.6%、热性惊厥30.8%、病毒性脑炎19.2%、中毒性脑病11.5%以及低血糖3.8%等。治疗总有效率为96.2%。结论高热、电解质紊乱(低血钙、低血镁、低血钠)等是导致婴幼儿腹泻伴惊厥的主要因素,及时明确病因可有效地对症治疗,终止惊厥发作。     

轻度胃肠炎合并婴幼儿良性惊厥患儿血清一氧化氮水平的研究

轻度胃肠炎合并婴幼儿良性惊厥(BICE)在临床中并不少见,既往因为对其认识不足,临床常将其诊断为急性肠胃炎合并癫痫,或者复杂性热性惊厥等。近年来,临床医师对该病的认识逐步增高,通过对BICE患儿血清一氧化氮水平的检测,初步探讨一氧化氮在BICE发病机制中所起的作用。1资料与方法1.1临床资料:选择2010年1月至2011年1月,山西省儿童医院诊断为BICE的住院患儿23例作为观察组,其中男     

儿童感染新型冠状病毒后神经系统表现的特征

目的探讨儿童感染新型冠状病毒后神经系统表现的特征。方法回顾性总结、分析2022年12月1日至2023年1月31日在山东大学附属儿童医院神经内科和重症监护室住院治疗的109例具有神经系统症状的新型冠状病毒阳性患儿的临床资料, 男58例, 女51例, 发病年龄为(55.5±43.9)个月。结果 109例患儿中, 有惊厥发作症状患儿85例(78.0%)[包括13例(11.9%)惊厥持续状态患儿], 意识障碍患儿10例(9.2%), 口角歪斜患儿3例(2.8%), 走路不稳患儿4例(3.7%), 语言障碍患儿4例(3.7%), 肌肉疼痛3例(2.8%)。最终诊断为热性惊厥患儿36例(33.0%), 脑炎患儿25例(22.9%), 急性坏死性脑病12例(11.0%), 急性坏死性脑病中包括放弃治疗患儿5例(4.6%), 死亡患儿2例(1.8%), 热性惊厥附加症患儿8例(7.3%), 周围性面神经麻痹3例(2.8%)。结论新型冠状病毒奥密克戎毒株感染后儿童最常见的神经系统症状为惊厥发作, 其次为意识障碍;最常见的神经系统疾病为热性惊厥、脑炎和急性坏死性脑病, 其中急性坏死性脑病可导致患儿死亡。     

儿童热性惊厥的临床特征

目的探讨热性惊厥住院患儿患病情况、影响因素等,以便为治疗及预防该疾病提供参考依据。方法采取回顾性研究方法,对某三甲儿童医院神经科2014年6月至2015年5月因首诊热性惊厥所收治出院的患儿1 129例进行调查,了解患儿病史,分析其年龄、性别构成、发病季节、生化指标值、贫血、腹泻等,找寻热性惊厥患儿患病的临床特征。结果 (1)在1 129例因热性惊厥住院患儿中,年龄最小的29 d,最大的11岁,其中男童683例,占60.5%;女童446例,占39.5%,男女比例为1.53∶1。虽然各年龄组因热性惊厥住院儿童人数构成均为男童高于女童,但经χ2检验,差异无统计学意义(χ2=4.098,P=0.129)。(2)热性惊厥发生月份以2014年12月至2015年1月患儿人数最多,占总患病人数的27.4%,5~6月份次之,占总患儿的20.2%。(3)不同年龄住院儿童热性惊厥合并低血钾、低血钠、癫痫及入院严重程度差异有统计学意义;不同性别、年龄住院儿童热性惊厥合并腹泻、缺铁性贫血差异有统计学意义。女性缺铁性贫血、腹泻患儿合并发热时发生惊厥的比例分别是9.4%、9.0%,大于男性缺铁性贫血及腹泻合并发热时发生惊厥的比例6.1%、4.8%。结论热性惊厥的发生与患儿年龄、性别、季节关系密切,山西省以冬季及春夏交界患病率最高;6岁以上热性惊厥患儿应注意合并低钠、低钾、癫痫等疾患;女性缺铁性贫血、腹泻患儿合并发热时惊厥发生概率大于男性患儿。     

轻度胃肠炎伴良性婴幼儿惊厥临床分析和远期随访研究

目的：研究轻度胃肠炎伴良性婴幼儿惊厥（BICE）的临床特点以指导临床治疗。方法：对2009年1月至2010年6月乌鲁木齐市儿童医院神经内科病房收治的21例BICE患儿的临床资料和出院后24～42月的随访结果进行回顾性分析。结果：21例BICE患儿男女比例为1：0．62;年龄8～26个月,其中12～24个月16例（76．2％）。发病季节9—11月份高发。惊厥发生时间无热惊厥后24h内出现急性胃肠炎（BE）者3例,在急性胃肠炎后第1～5天出现惊厥18例,以3d内最多（76．1％）。13例（61．9％）出现2次以上惊厥,平均发作次数为2．1次,9次惊厥因疼痛哭闹所诱发（20．5％）,惊厥持续时间40S～3min,无惊厥持续状态,发作形式为全面强直一阵挛发作。4例有热性惊厥家族史。发作间期监测V—EEG,3例睡眠期见两枕部、中央区低-中波幅不典型尖慢波散发,5例见睡眠纺锤波及慢波改变,3例头颅CT示外部性脑积水,其余未见异常。13例（61．9％）大便轮状病毒抗原阳性,8例阴性。出院后18例进行24～42个月随访,无1例复发,精神运动发育正常。结论：BICE1～2岁发病率高,以秋冬季多见。轮状病毒为主要病因,部分患儿有热性惊厥家族史。惊厥多发生在急性胃肠炎病程1～3d,早期频繁发作,但无惊厥持续状态,发作形式为全身强直一阵挛发作,发作间期EEG及头颅影像学正常。预后良好。     

儿童病毒性脑炎继发癫痫的临床特征及脑电图分析

目的 探讨儿童病毒性脑炎继发癫痫的临床特征及脑电图情况.方法 以确诊病毒性脑炎继发癫痫的46例患儿为观察组,随机抽取同期无继发性癫痫的病毒性脑炎住院患儿69例为对照组;分析观察组继发性癫痫的临床特征及脑电图情况,并比较两组大脑皮质损伤及脑电图检查情况.结果 观察组部分性癫痫发作35例,全面性癫痫发作11例,出现癫痫持续状态9例,非癫痫持续状态37例,发作1次者11例,2～6次者29例,＞7次者6例;患儿脑电图显示爆发或长程阵发癫痫波或高幅慢波阵发,异常θ、δ波持续出现25例、阵发性出现16例、双侧不对称5例;观察组大脑皮质损伤发生率、脑电图重度异常率明显高于对照组,差异有统计学意义(P＜ 0.01).结论 临床医师应掌握病毒性脑炎继发性癫痫的临床特征及脑电图变化,积极控制惊厥,及时控制癫痫发作,减少癫痫再发,提高临床疗效,改善患儿预后.     

神经肽Y和神经元特异性烯醇化酶在小儿惊厥性疾病中的变化

目的 探讨神经肽Y (NPY)和神经元特异性烯醇化酶(NSE)在小儿惊厥性疾病中的水平变化及其临床意义.方法 选择惊厥患儿62例,正常对照组20例.采用放射免疫法测定血浆NPY水平,酶联免疫法测定血清NSE水平.结果 惊厥组(病毒性脑炎、癫痫和热性惊厥)惊厥发作后24 h内血液NPY和NSE水平均显著高于正常对照组(P＜0.01).患儿惊厥发作后24 h内血液NPY和NSE水平均显著高于正常对照组(P＜0.01).惊厥严重组患儿NSE水平显著高于普通组,而NPY水平显著低于普通组(P＜0.01).惊厥患儿急性期NPY与NSE呈负相关(r＝-0.74,P＜0.01).结论 小儿惊厥性疾病(病毒性脑炎、癫痫和热性惊厥)惊厥发作后可引起血液NPY和NSE水平的显著升高,其水平高低与脑损伤严重程度密切相关,可作为早期判断惊厥性脑损伤的客观指标.     

轻度胃肠炎伴良性婴幼儿惊厥临床分析及远期随访观察

轻度胃肠炎伴良性婴幼儿惊厥(benign infantile convul-sions associated with mild gastroenteritis,BICE)临床上并不少见,以往由于对这种疾病缺乏认识,难以给它下一个确切的诊断名称,造成诊断与治疗的混乱,如本组病例早期曾诊断过腹泻并复杂性热性惊厥、腹泻并癫痫、病毒性脑     

258例小儿热性惊厥首次发作临床特征分析

目的:探究并分析258例小儿热性惊厥首次发作临床特征,旨在为临床预防小儿热性惊厥提供参考依据。方法:收集2018年1月—2021年12月期间在我院住院治疗的热性惊厥患儿258例,作为本次研究对象。收集患儿的临床资料,如首次惊厥年龄、惊厥类型、惊厥持续时间、发热原因等资料,回顾性分析258例患儿首次发作的临床特征。结果:258例患儿热性惊厥首次发作中男孩居多,构成比54.65%;年龄段中6个月<年龄≤3岁最多,构成比65.89%;发病季节多见于7～9月,构成比37.21%;伴癫痫家族史构成比11.24%,伴热性惊厥家族史构成比20.93%;体温段中38℃<体温≤40℃发作居多,构成比70.16%;以全面性发作居多,构成比64.34%;首次发作中以惊厥发作持续时间<5min居多,构成比56.20%;惊厥首次发作以脑电图异常居多,构成比56.20%;惊厥发作临床分型中以单纯性为主,构成比89.15%。258例患儿热性惊厥首次发作诱因中以上呼吸道感染居多,占比53.49%;其次为疱疹性咽峡炎,占比25.97%,第三为幼儿急疹,占比10.47%。结论:小儿热性惊厥首次发作主要为...     

丙戊酸钠在病毒性脑炎癫痫型中的应用

目的观察丙戊酸钠在病毒性脑炎癫痫型中的疗效,探讨病毒性脑炎伴频繁惊厥患儿应用丙戊酸钠治疗的价值。方法对确诊为病毒性脑炎癫痫型患儿小剂量应用丙戊酸钠[10~20 mg/(kg.d)],观察其惊厥控制情况和不良反应。结果丙戊酸钠对控制病毒性脑炎癫痫型效果良好,且无明显不良反应。结论对病毒性脑炎癫痫型中频繁惊厥发作患儿,宜选用丙戊酸钠,副作用小,效果好,值得临床应用。     

卡马西平联用尼美舒利相关粒细胞缺乏症

1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠（2.25 g静脉滴注,1次/d）、卡马西平（0.2 g口服,2次/d）、尼美舒利（100 mg口服,2次/d）、二羟丙茶碱（0.5 g静脉滴注,1次/d）、甲钴胺（0.5 mg口服,3次/d）、地塞米松（5 mg,静脉滴注1次）、盐酸哌替啶（25 mg,肌内注射1次）和盐酸布桂嗪（100 mg,肌内注射3次）等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠（8 g静脉滴注,1次/d）。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。     

颅脑损伤患者并发肺部感染的护理体会

目的：为了使并发肺部感染的病人更多、更好、更早的痊愈。方法：通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果：痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

甘草酸单铵结合氦-氖激光治疗银屑病62例

目的用甘草酸单铵结合低能量氦-氖激光,观察治疗银屑病患者。方法62例寻常型银屑病患者,分为两组,A组用低能量氦-氖激光血管内照射,同时用甘草酸单铵静脉滴注,共36例;B组仅用甘草酸单铵,共26例。通过30d治疗。结果总有效率82.2%,其中A组有效率88.9%,B组73.1%(经Ridit检验,U＝2.76,P＜0.01),两组差异有极显著性意义。结论甘草酸单铵结合氦-氖激光治疗银屑病,比单用甘草酸单铵效果好。     

A fetus with meckel-gruber syndrome associated with isomerism

Abstract. Meckel-Gruber syndrome (MKS) is an autosomal recessive lethal malformation. As far as we know, the rate of incidence for the syndrome is 0.02 per 10,000 births. It is estimated that Meckel-Gruber syndrome accounts for 5% of all neural tube defects in Finland. Objective. The aim of this study is to present a case of a fetus with Meckel-Gruber syndrome associated with complete left isomerism. Method. The fetus was obtained after medical interruption of the pregnancy during the fifteenth gestational week. The mother was 36 years old and in a consanguineous marriage. The antenatal ultrasound examination revealed a polymalformative syndrome, leading to a postmortem examination. The fetopathological study of the fetus was conducted at the Centre for Maternity and Neonatology, Tunis, Tunisia, in 2008. Results. The female fetus had a significantly deformed ballooning abdomen, pes equinovarus, flexion of the wrist and a total posterior cleft palate. The central nervous system abnormalities were occipital encephalocele, cystic dilatation of the fourth ventricle, agenesis of corpus callosum and hydrocephalus. The study of the internal organs found dextrocardia, irregular lobulation of the lungs, left isomerism, and polysplenia. The microscopic examination revealed bilateral cystic dilation of the kidneys, fibrous proliferation of the liver and ectasic dilatation of the billiary ducts, representing a ductal plate malformation of the liver. Conclusion. The case is diagnosed with Meckel-Gruber syndrome associated with complete left isomerism, cleft palate and possibly Dandy-Walker syndrome.