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目的探讨新生儿惊厥的病因和治疗方法。方法回顾分析60例新生儿惊厥患儿的临床特点、治疗与转归。结果 60例患儿中36例合并新生儿缺氧缺血性脑病和/或颅内出血,12例合并低血糖、低钙血症,合并感染8例,核黄疸、脑发育畸形及不明原因4例;惊厥发生于出生24h内36例,出生1~3d15例,>3~7d8例,>7d1例;以微小型发作为主38例,阵挛发作8例,强直-阵挛型5例,肌阵挛型5例,强直发作4例;经苯巴比妥单药治疗46例,联合或改用左乙拉西坦口服液单药治疗14例;治疗7~14d,48例治愈,7例好转,3例放弃治疗,2例因多器官功能衰竭死亡。结论新生儿缺氧缺血性脑病、新生儿颅内出血以及低血糖、低钙血症是导致新生儿惊厥的主要病因,苯巴比妥可作为抗惊厥治疗首选药物,联合或单独应用左乙拉西坦效果良好。
Objective To investigate the etiology and treatment of neonatal convulsion. Methods The clinical features, treatment and outcome of 60 neonates with convulsions were retrospectively analyzed. Results Thirty-six of 60 children with neonatal hypoxic-ischemic encephalopathy and / or intracranial hemorrhage, 12 with hypoglycemia and hypocalcemia, 8 with combined infection, 4 with kernicterus, brain deformity and unknown cause ; Seizures occurred in 24h within 36 births, birth 1 ~ 3d15 cases,> 3 ~ 7d8 cases,> 7d1 cases; the main micro-attack in 38 cases, 8 cases of clonic seizures, tonic-clonic type in 5 cases, muscle 5 cases of clonus and 4 cases of tonic attack. Forty-six cases were treated with phenobarbital monotherapy, 14 cases were treated with levetiracetam oral liquid alone, and 7 cases were cured with 14 cases, 48 cases were cured and 7 cases were cured Improvement, 3 patients to give up treatment, 2 patients died of multiple organ failure. Conclusion Neonatal hypoxic-ischemic encephalopathy, neonatal intracranial hemorrhage and hypoglycemia, hypocalcemia is the leading cause of neonatal seizures, phenobarbital can be used as the first choice of anti-convulsive drugs, combined or alone Zibei pull West Tanzania good effect.