小儿发热伴惊厥的病因及相关因素160例分析

目的探讨小儿发热伴惊厥的病因及相关因素。方法对160例发热伴惊厥病人的病因、首发年龄、再发次数、惊厥程度、惊厥时体温、脑电图改变、家族史及电解质变化等临床因素与惊厥的病因及预后进行分析。结果发热伴惊厥病人中75．6％为高热惊厥(febrile convulsion，FC)，20．6％为中枢感染，另有少数中毒性脑病及感染后脑炎。高热惊厥中33例复发，复发率为27％；复发与首发年龄、惊厥程度、发作时体温、家族史有关，发作后脑电图异常也易复发；再发与血钠钙浓度下降有关。结论发热伴惊厥病人应重视中枢感染，脑电图有很大帮助。对于FC病人，进行全面的评估，包括首发年龄、再发次数、惊厥程度、惊厥时体温、脑电图改变、家族史及电解质变化。并采取相应措施可防止复发或再发。

Analyses of Etiology and Associated Factors on 160 Children with Fever and Convulsion

Objective To explore the causes and associated factors of childhood fever and convulsion.Methods Analyses of etiology,age of first onset,recurrent times,extent of convulsion,body temperature at onset,changes of electroencephalogram (ECG),family history and electrolytes were performed on 160 cases children with fever and convulsion.Results Of all the patients studied,121 cases (75.6%) were febrile convulsion (FC),33 cases (20.6%) were central nervous system (CNS) infections,and the other patients were toxic encephalopathy and encephalitis after infection.Thirty-three patients of FC recurred,which were associated with age of first onset,extent of convulsion at onset,body temperature at onset and family history.The ECG were usually abnormal after recurrence,and recurrence were always concomitant with lower serum concentration of calcium and natrium.Conclusion Attention must be paid on the CNS infection in patients with convulsion,while ECG might be helpful in diagnosis and prognosis.As for patients with FC,general evaluation of all the factors mentioned above must be considered and certain measures must be taken in order to avoid recurrence.