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埃塞俄比亚贡德尔大学医院收治新生儿癫痫发作的病因、临床特征及短期预后

Etiology, Clinical Features, And Short-Term Outcome Of Seizures In Newborns Admitted To The University Of Gondar Hospital, Ethiopia.

作者信息

Amare Hailu Tazebew, Amare Ashenafi Tazebew

机构信息

Department of Pediatrics and Child Health, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia.

出版信息

Pediatric Health Med Ther. 2019 Oct 18;10:107-113. doi: 10.2147/PHMT.S228241. eCollection 2019.

Abstract

BACKGROUND

Neonatal seizures are the most common neurological dysfunction in the neonatal period. Neonatal seizure patterns and short-term neurologic outcomes, particularly in the Ethiopian context, have not been adequately studied.

OBJECTIVE

The main aim of this study is to assess the pattern, probable etiology, short-term outcomes, and determinants of neonatal seizures in the neonatal intensive care unit of Gondar University Specialized Comprehensive Hospital.

METHODS

A hospital-based prospective observational cohort study was conducted from October 1, 2016, to September 30, 2018.

RESULTS

Among the 117 neonates enrolled, the most common type of neonatal seizure was subtle (60.6%), followed by tonic (15.4%), and clonic (12.8%) seizures. The most common etiology for the seizure was perinatal asphyxia (PNA) with hypoxic-ischemic encephalopathy (HIE; 74.4%) followed by electrolyte disturbances (12.8%). In the follow-up, 23 (19.7%) died during the acute neonatal illness. The most common cause of death was PNA with HIE, accounting for 73.9% of the deaths. Among the surviving newborns, 10 (10.6%) had neurodevelopmental deficits at discharge. Being a multiparous mother (OR= 0.172; 95% CI: 0.033, 0.880), being female (OR= 0.171; 95% CI: 0.055, 0.538), and having tonic (OR= 0.164; 95% CI: 0.030, 0.885) and myoclonic seizures (OR= 0.040; 95% CI: 0.055, 0.538) were significantly associated with mortality poor short-term outcome.

CONCLUSION

Subtle seizures were the most common seizure semiology. The most common etiology for seizure was PNA with HIE. Parity, gestational age, neonatal sex, and seizure type were determinants of short-term outcomes.

摘要

背景

新生儿惊厥是新生儿期最常见的神经功能障碍。新生儿惊厥模式和短期神经学预后,尤其是在埃塞俄比亚的背景下,尚未得到充分研究。

目的

本研究的主要目的是评估贡德尔大学专科医院新生儿重症监护病房新生儿惊厥的模式、可能病因、短期预后及决定因素。

方法

于2016年10月1日至2018年9月30日进行了一项基于医院的前瞻性观察队列研究。

结果

在纳入的117例新生儿中,最常见的新生儿惊厥类型为轻微惊厥(60.6%),其次是强直性惊厥(15.4%)和阵挛性惊厥(12.8%)。惊厥最常见的病因是围产期窒息(PNA)合并缺氧缺血性脑病(HIE;74.4%),其次是电解质紊乱(12.8%)。在随访中,23例(19.7%)在急性新生儿疾病期间死亡。最常见的死亡原因是PNA合并HIE,占死亡人数的73.9%。在存活的新生儿中,10例(10.6%)在出院时存在神经发育缺陷。多胎母亲(OR = 0.172;95%CI:0.033,0.880)、女性(OR = 0.171;95%CI:0.055,0.538)以及强直性惊厥(OR = 0.164;95%CI:0.030,0.885)和肌阵挛性惊厥(OR = 0.040;95%CI:0.055,0.538)与短期预后不良显著相关。

结论

轻微惊厥是最常见的惊厥表现形式。惊厥最常见的病因是PNA合并HIE。产次、胎龄、新生儿性别和惊厥类型是短期预后的决定因素。

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