轻度胃肠炎伴婴幼儿良性惊厥临床剖析及随访.docVIP

轻度胃肠炎伴婴幼儿良性惊厥临床剖析及随访 　　[摘要] 目的 加深对轻度胃肠炎伴婴幼儿良性惊厥（BICE）的认识，为正确诊断和合理治疗提供资料。 方法 随机选取该院2012年8月―2014年5月住院治疗的32例符合BICE诊断标准的病例进行回顾性分析和随访，了解有无惊厥复发和精神运动发育状况。 结果 32例 BICE年龄9个月～3岁。起病48 h内发生惊厥28例，48 h后发病4例。惊厥均全身强直-阵挛发作，每次持续时间不超过8 min，病程中惊厥平均每人次发作2.9次。呕吐、腹泻及脱水症状不严重，肝肾功能、电解质、脑脊液正常，头颅CT正常。脑电图轻度异常5例，中度异常1例，这6例出院后门诊复查脑电图均恢复正常。1例失访，1例复发热性惊厥2次；生长发育均正常。 结论 BICE预后良好，无需长期抗癫病治疗。明确BICE的临床表现以及良好预后，有助于指导临床医生制定诊疗方案，避免误诊误治。 　　[Abstract] Objective To deepen the outstanding of mild gastroenteritis with benign infantile convulsions （BICE） and provide data for correct diagnosis and rational treatment. Methods 32 cases meeting the diagnostic standard of BICE treated in our hospital from August 2012 to May 2014 were retrospectively analyzed and followed up， whether the convulsions recurred or not and the psychomotor development were known. Results In the 32 cases with BICE whose age was from 9 months to 3 years old， convulsions occurred to 28 cases in 48h of onset and occurred to 4 cases after 48h of onset， all convulsions showed generalized tonic-clonic seizures and each duration time was less than 8min， there were mean 2.9 convulsions per person during the disease course， the symptoms including vomiting， diarrhea and dehydration were not severe， the hepatic and renal function， electrolyte， cerebrospinal fluid and head CT were normal， the electroencephalogram was mild abnormal in 5 cases and moderate abnormal in 1 case， and the electroencephalograms of these 6 cases returned to normal by outpatient reexamination after discharge， 1 case was lost to follow-up， 1 case was with the recurrence of 2 febrile convulsions， and the growth and development were normal. Conclusion The prognosis of BICE is good， and it doesn’t need long-term antiepileptic treatment， making the clinical performance of BICE clear and good prognosis contribute to guiding the clinical doctors to make the diagnosis and treatment plan and avoid misdiagnosis and mistreatment . 　　[Key words] Gastroenteritis； Infantile； Convulsions