摘要
Abstract
Objective To analyze the clinical characteristics and clinical outcomes of the children with FIRES at acute stage,aiming to find the risk factors related to prognosis and provide reference for clinical decision of FIRES.Methods This is a retrospective single-center cohort study,in which the clinical data of all FIRES children hospitalized in Children's Hospital of Chongqing Medical University from June 2015 to June 2021 were analyzed.These children were followed up and their prognoses were evaluated by modified Rankin score,and then they were divided into groups for summary and analysis.Results A total of 54 children were included in this study,including 30 males and 24 females.The median onset age was 5.9 years.There were 11 toddlers(20.4％),18 preschool children(33.3％),and 25 school-age children(46.3％).During the follow-up,3 children died and 2 were lost to the follow-up.The median follow-up period was 44 months for the other children.On discharge,31 cases(57.4％)were classified as good prognosis while the other 23(42.6％)as poor prognosis.There were 44 cases(84.6％)with good prognosis and 8 cases(15.4％)with poor prognosis at 1 year after discharge.With the extension of survival time,the mRS score was apparently improved,and the prognosis tended to improve.Overall,44 children(89.8％)developed secondary epilepsy at the chronic stage,of which 61.4％(27 cases)were drug-resistant epilepsy.41 children(83.7％,41/49)had neurological sequelae,inclu-ding motor impairment(n=7),mental retardation(n=30)and neurobehav-ioral abnormalities(n=10).The types of anesthetics used in combination(OR=11.67,95％CI 2.09-65.18,P=0.005)in acute stage were independent risk factors for the poor prognosis on discharge.Conclusion Most FIRES children have good prognosis after treatment.During one-year follow-up period,most of the children present with epilepsy at chronic stage,and may have different degrees of neurological sequelae,but their neurological function gradually improves over time.The types of anesthetics used in combination in the acute phase are the independent risk factors of poor prognosis of FIRES on discharge.关键词
儿童/发热/癫痫综合征/预后因素/癫痫持续状态Key words
child/fever/epilepsy syndrome/prognostic factors/status epilepticus分类
医药卫生
