Rutter N, Metcalfe D H
Br Med J. 1978 Nov 11;2(6148):1345-6. doi: 10.1136/bmj.2.6148.1345.
To find out about the medical and parental management of children having their first febrile convulsion a hospital-based questionnaire study was carried out in which parents were asked what they did at the time. Fifty-four out of 89 parents brought their child directly to hospital while the remainder attempted to contact their general practitioner, usually successfully, and were then referred to hospital. Whichever course of action the parents chose the outcome was satisfactory. Eighty-seven per cent of convulsions lasted for less than 15 minutes and in only two instances did they last longer than 30 minutes. One child who had convulsions for an hour was given intramuscular phenobarbitone at home without success, and the fit was finally terminated with intravenous diazepam. Parental management of the fit was often widly inappropriate. Only a few parents laid the child on his side and waited for the fit to stop. The parents were bewildered and frightened--30% thought their child was dying or dead. Education of patents of young children is needed. Simply written instructions on how to reduce the temperature of a febrile child and manage a convulsion might help.
为了了解首次热性惊厥儿童的医疗及家长处理情况，开展了一项基于医院的问卷调查研究，询问家长孩子发病时他们采取了什么措施。89位家长中，有54位直接带孩子去了医院，其余家长则试图联系他们的全科医生，通常都成功联系上了，随后被转诊至医院。无论家长选择哪种做法，结果都令人满意。87%的惊厥持续时间不到15分钟，只有两例持续时间超过30分钟。有一个孩子惊厥持续了一小时，在家中注射苯巴比妥无效，最终通过静脉注射地西泮才终止惊厥。家长对惊厥的处理往往非常不当。只有少数家长让孩子侧卧并等待惊厥停止。家长们既困惑又害怕——30%的家长认为他们的孩子快要死了或已经死了。需要对幼儿家长进行教育。提供关于如何降低发热儿童体温及处理惊厥的简单书面说明可能会有所帮助。
