การทบทวนการรักษาเบื้องต้นในผู้ป่วยเด็กที่มีภาวะชักจากไข้สูงของโรงพยาบาลโพธาราม

บทคัดย่อ

A retrospective study was performed in 246 records of children admitted in Photharam hospital  with a febrile convuIsion during January 1998-December 1999. Most of the diagnosis for the cause of fever was URI (51.2%) while 13.4% had no diagnosis. Fifty percent of the group received an antibiotic which most of it was Amoxycillin (41.9%).

Of the 35 cases who had acute seizure in the outpatient department or in an emergency room,  18 cases receiving Diazepam (DZP) intravenously, rectally or intramuscularly. Of the 17 cases whose seizure ceased before receiving DZP, 6 cases had intravenous or rectal DZP as needed for seizure, and  11 cases without DZP as needed order, 9 cases receiving Phenobarbitai injection.

Treatment for prevention of subsequent seizures was found to be without anticonvulsive drug   22.3%, with Phenobarbital : oral without injection 23.6%, injection and oral 15.4%, and injection without oral 9.7%, with DZP as needed for seizure : intravenously 17.9%, rectally 11% and intramuscularly 2.8%, and with oral DZP 14.6%.

The management of febrile seizure concerning the routes of administration and dosages of medication were discussed. This study found that the dosage of intravenous DZP was too low in at least 25% and for oral DZP, there was no any patient received a recommended dose of 1 mg/kg/day. Clinical practice guideline on febrile seizure should be developed.