摘要
目的探讨急性期发生惊厥的化脓性脑膜炎患儿的临床表现、影像学及脑电图（EEG）检查等相关因素分析。方法回顾性分析本院收治的301例化脓性脑膜炎患儿的临床资料，其中62例出现急性期惊厥发作，分析化脓性脑膜炎急性期发生惊厥的发病率、相关危险因素及转归。结果化脓性脑膜炎急性期惊厥的发病率为20．60％，部分性发作8例（占12．90％），部分性发作继发全身性发作15例（占24．19％）；全身性发作32例（占51．61％）％，惊厥持续状态7例（占11．29％），有惊厥发作组脑电图异常率高于无惊厥发作组（P〈0．05），脑器质性损害发生率高于无惊厥发作组（P〈0．05）。经多因素非条件Logistic回归分析，病因、首发症状、意识障碍、阳性体征及脑脊液培养阳性与惊厥发作为相关因素（P〈0．01）。结论化脓性脑膜炎急性期惊厥发作以全面性发作为主，脑器质性损害易继发惊厥发作，惊厥发作与病因、首发症状、意识障碍、阳性体征及脑脊液培养阳性相关，结合临床表现、头颅影像学及EEG异常对本病的诊治及预后评估具有指导意义。
Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations, imaging and electroencephalograph （EEG） examination of purulent meningitis. Methods Cluster sampling method was employed to select children in our hospital, a total of 301 cases with purulent meningitis was analyzed retrospectively. Among them, 62 cases had convulsion. The incidence of convulsion in the acute phase of the purulent meningitis, risk factors, and prognosis were analyzed. Results The convulsion incidence rate of acute purulent meningitis was 20. 60%. The partial seizure was eight cases （ 12. 90% ）. The secondarily generalized seizure following partial seizure was 15 ca- ses （24. 19% ）. The generalized seizure was 32 cases （51.61%）. The convulsive status was 7 cases （ 11.29% ）. The EEG abnormality was significantly different between the convulsion group and the no con- vulsion group （ P 〈 0.05 ）. The incidence of brain organic damage was significantly different between two groups （ P 〈 0. 05 ） . The multivariate unconditional logistic regression analysis showed, cause of disease, first symptom, disturbance of consciousness, obvious signs, and cerebrospinal fluid culture with convulsion were the relevant factors （ P 〈 0. 01 ）. Conclusions The most common seizure of purulent meningitis was the generalized seizure. Brain organic damage easily resulted in convulsion of purulent meningitis. The days of hospitalization, cause of disease, first symptom, disturbance of consciousness, obvious signs, and eere- brospinal fluid culture with convulsion were the positively relevant factors. Those positively relevant factors in combination of the clinical manifestations, imaging, and EEG examination in children would play an im- portant role in diagnosis, treatment, and prognosis evaluation of convulsion derived from purulent meningi- tis. Moreover, convulsion affects the disease recovery in children with purulent meningitis.
出处
《中国医师杂志》
CAS
2013年第5期636-639,共4页
Journal of Chinese Physician
关键词
脑膜炎
惊厥△
儿童
Meningitis
CONVULSIONS A
Child
