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目的 了解热性惊厥的初发月龄和病因、临床表现、预后等多因素的关系。 方法 对因热性惊厥(FC)住院的 15 6例患儿进行随访 ,采用问卷调查表调查 ,并统计住院病历相关资料。 结果 完成随访 92例 ,早期发作组 (初发月龄 <18月 )有以下特征 :(1)初发时体温较低 ,39℃以下诱发 FC发生率高 ;(2 )出生时异常 ,如产伤、窒息、颅内出血、早产、低出生体重等对本组发病影响较大 ;(3)家族遗传因素影响大 ;(4)复发率高 ;(5 )发作持续时间长 ;(6 )转变为无热惊厥率高 ;(7)脑电图 (EEG)异常率低。晚期发作组 (初发月龄 >31月 )有以下特征 :(1)初发时体温高 ;(2 )出生异常史较少 ;(3)具有家族史者少 ;(4)大多数仅发作一次 ;(5 )发作持续时间长 ;(6 )转变为无热惊厥者少 ;(7) EEG异常率高。 结论 初发月龄与 FC的临床表现、复发以及转变为无热惊厥等不良预后密切相关。预防 FC复发 ,减少不良后遗症 ,改善预后 ,关键在于积极防治早期发作的 FC。
Objective To understand the onset of febrile seizures and etiology, clinical manifestations, prognosis and other factors. Methods A total of 15 6 hospitalized children with febrile seizures (FC) were followed up, and questionnaires were used to survey the data of hospitalized patients. Results The follow-up was completed in 92 cases. The early-onset group (initial onset age <18 months) had the following characteristics: (1) low initial body temperature and high incidence of FC below 39 ° C; (2) abnormalities at birth, Injury, asphyxia, intracranial hemorrhage, premature delivery, low birth weight and so on have a greater impact on the incidence of this group; (3) the impact of family genetic factors; (4) the recurrence rate is high; (5) the attack lasts long; Febrile seizures high; (7) EEG abnormal rate is low. The late-onset group (first trimester> 31 months) had the following characteristics: (1) high body temperature at first trimester; (2) less history of abnormal birth; (3) less family history; (4) Once; (5) the duration of the attack is long; (6) the transition to no febrile seizures less; (7) EEG abnormal rate. Conclusions The age of first trimester is closely related to the clinical manifestations, recurrence of FC and the unfavorable prognosis such as no febrile seizures. FC to prevent recurrence, reduce adverse sequelae and improve prognosis, the key is to actively prevent and treat early onset of FC.