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目的分析轻度胃肠炎伴婴幼儿良性惊厥(BICE)的临床特点及预后;方法对2013年1月-2016年2月住院治疗的轻度胃肠炎伴婴幼儿良性惊厥患儿48例进行临床观察,收集患儿年龄、性别、惊厥发生年龄、出现时间、发生频率、持续时间、发作类型、首发时脑电图特点、家族史、影像学特点等数据,病愈后进行2~39个月随访,回顾分析其临床特点及预后。结果在48例患儿中年龄最小5个月,最大33个月;男女比例5∶7;腹泻1d出现惊厥者11例,腹泻2d出现惊厥者9例,腹泻3d以上出现惊厥者28例;腹泻后仅有1次惊厥者32例,2次惊厥者10例,3次以上惊厥者6例;惊厥持续时间小于5min者34例,持续5min以上者14例;48例患儿中38例为全面性发作,10例为局灶性发作。惊厥发作1周内脑电图异常者15例;48例患儿中7例有惊厥家族史;影像学检查中7例存在异常,余41例未见异常。随访6例复发,占12.50%,其中脑电图异常者5例,考虑诊断癫痫。结论轻度胃肠炎伴婴幼儿良性惊厥患儿多数预后良好,但少数存在复发,初期脑电图异常可能为高危因素,需长期随访观察。
Objective To analyze the clinical characteristics and prognosis of mild gastroenteritis with infantile benign convulsion (BICE). Methods Forty-eight children with mild gastroenteritis and infantile benign convulsion admitted to hospital from January 2013 to February 2016 were enrolled in this study. The clinical data were collected from 2 to 39 patients with age, gender, age at onset of seizures, frequency of occurrence, frequency of occurrence, duration, type of seizure, characteristics of EEG at first episode, family history and imaging features. Follow-up, retrospective analysis of its clinical features and prognosis. Results Among the 48 children, the youngest was 5 months and the maximum was 33 months. The ratio of males to females was 5: 7. There were 11 cases of seizures on day 1 of diarrhea, 9 cases of seizures on day 2 of diarrhea, 28 cases of seizures over 3d days of diarrhea. After only 1 convulsion in 32 cases, 2 cases of convulsions in 10 cases, more than 3 times convulsions in 6 cases; convulsions less than 5min in 34 cases, lasting 5min or more in 14 cases; 48 cases of children in 38 cases Sexual attack, 10 cases of focal attack. There were 15 cases of abnormal EEG within 1 week after convulsion seizure; 7 of 48 cases had family history of convulsion; 7 cases were abnormal in imaging examination and no abnormality was found in 41 cases. Follow-up 6 cases of recurrence, accounting for 12.50%, of which 5 cases of abnormal EEG, consider the diagnosis of epilepsy. Conclusions Most children with mild gastroenteritis and infantile benign convulsion have a good prognosis, but few have recurrence. The initial EEG abnormalities may be risk factors and need long-term follow-up.