การตรวจทางห้องปฏิบัติการในผู้ป่วยเด็กอายุ 6 เดือน ถึง 5 ปี ที่ป่วยด้วยภาวะชักร่วมกับการมีไข้ในโรงพยาบาลสมเด็จพระสังฆราชองค์ที่ 17

บทคัดย่อ

     Objectives: To analyze the value of performing laboratory tests and suggest practical guideline of investigations in a simple febrile seizure. Another aim of this study was to identify the most common sources of fever in patients with simple febrile seizures.
     Methods: Inpatient medical records of children aged 6 months to 5 years with simple febrile seizures seen at Somdejprasangkharach 17th Hospital during January to December 2012 were reviewed. Variables such as age, sex, the source of fever, all laboratory tests included CSF examination and management plan based on biochemical abnormalities were carefully recorded.
     Results: There were 142 patient encounters, 57.7% of which were boys. The mean age was 1 year and 7 months. Upper respiratory tract infection, fever without localizing signs and lower respiratory tract infection were the most common diagnoses attributed to the fever. CBC was measured in 140 cases (98.6%). 32 of these (22.9%) were anemia. UA was measured in 33 cases (23.2%). Urinary tract infection was detected in 3 cases (9.1%). Blood glucose was measured in 104 cases (73.2%). Temporary hyperglycemia was common. Electrolyte was measured in 132 cases (93.0%). Hypokalemia was found in 4 cases (3.0%) and low bicarbonate levels were also found in patients who had dehydration status. Mild hypocalcemia was also found but unlikely to be the cause of convulsions.
Conclusion: This study concluded that CBC and UA were useful investigations in simple febrile seizures. Electrolyte should be individualized to each case and correlated with clinical symptoms such as dehydration status. Blood sugar and calcium were found to be unhelpful.