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热性惊厥患儿的评估与治疗

Evaluation and treatment of the child with febrile seizure.

作者信息

Millar James S

机构信息

University of Oklahoma-Tulsa College of Medicine, Tulsa, Oklahoma, Department of Family Medicine, 74120, USA.

出版信息

Am Fam Physician. 2006 May 15;73(10):1761-4.

Abstract

Up to 5 percent of children in North America and western Europe experience at least one episode of febrile seizure before six years of age. Most of these seizures are self-limited and patients do not require treatment. Continuous therapy after the seizure is not effective in reducing the development of afebrile seizures. Antipyretics are effective in reducing the risk of febrile seizures if given early in the illness. Immediate care for the patient who has had a febrile seizure includes stopping the seizure, if prolonged, and evaluating the patient for the cause of the fever. Bacterial infections are treatable sources of fever but are not usually the cause of the fever that triggers a seizure. The patient must be assessed for these treatable sources. Long-term consequences of febrile seizure are rare in children who are otherwise healthy. Current recommendations do not support the use of continuing or intermittent neuroleptic or benzodiazepine suppressive therapies after a simple febrile seizure.

摘要

在北美和西欧,高达5%的儿童在6岁前至少经历过一次热性惊厥。这些惊厥大多是自限性的,患者无需治疗。惊厥发作后持续治疗对减少无热惊厥的发生无效。如果在疾病早期给予退烧药,可有效降低热性惊厥的风险。对热性惊厥患者的即时护理包括,如果惊厥持续时间较长则终止惊厥,并评估患者发热的原因。细菌感染是可治疗的发热源,但通常不是引发惊厥的发热原因。必须对患者进行这些可治疗源的评估。在其他方面健康的儿童中,热性惊厥的长期后果很少见。目前的建议不支持在简单热性惊厥后使用持续或间歇性的抗精神病药物或苯二氮䓬类抑制疗法。

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