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Neurology:儿童难治性癫痫持续状态怎么办?

2016-12-24 haofan MedSci原创

该研究结果表明没有癫痫早期诊断的rSE儿童不能得到更多的及时处理;然而,SE病史与更及时的药物中断管理相关。

近日,神经病学领域权威杂志Neurology上发表了一篇研究文章,研究者旨在比较有无癫痫早期诊断和有无癫痫持续状态病史的儿童难治性癫痫持续状态(rSE)管理和预后。

这是一项前瞻性观察性研究,在2011年6月到2016年5月期间,在患有rSE的儿童(1个月龄–21岁)中进行。

研究人员招募了189名参与者(53%名男性),中位年龄为(第25-75位百分位数)4.2岁(1.3-9.6岁)。89名(47%)患者早期有癫痫诊断。34名(18%)患者有SE病史。


研究者发现在有无癫痫早期诊断的患者中第一次接受苯二氮卓类药物的时间是相似的(15[5-60] vs. 16.5 [5-42.75]分钟,P=0.858)。在诊断癫痫的患者中接受了他们的第一次非苯二氮类(BZD)抗癫痫药(AED)较晚后(93 [46-190] vs. 50.5 [28-116]分钟,P=0.002),并且接受至少一个的连续输注药物的比例较少(35/89 [39.3%] vs. 57/100 [57%],P=0.03)。

相比于无SE病史的患者,有SE病史的患者较早地接受了他们的第一次BZD(8 [3.5-22.3]vs. 20 [5-60]分钟,P=0.0073),虽然他们第一次接受非BZDAED的时间也类似(76.5 [45.3-124] vs. 65 [32.5–156]分钟,P=0.749)。差异主要是由院外的rSE患者发病所引起。

该研究结果表明没有癫痫早期诊断的rSE儿童不能得到更多的及时处理;然而,SE病史与更及时的药物中断管理相关。

原始出处:

Iván Sánchez Fernández, et al. Refractory status epilepticus in children with and without prior epilepsy or status epilepticus. Neurology.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1999794, encodeId=61b11999e9404, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Jun 23 20:34:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528334, encodeId=a71f1528334e4, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Mon Dec 26 06:34:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=165577, encodeId=eaaa1655e786, content=癫痫持续状态,对大脑的神经损害,挺严重的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun Dec 25 12:32:47 CST 2016, time=2016-12-25, status=1, ipAttribution=)]
    2017-06-23 yinhl1978
  2. [GetPortalCommentsPageByObjectIdResponse(id=1999794, encodeId=61b11999e9404, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Jun 23 20:34:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528334, encodeId=a71f1528334e4, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Mon Dec 26 06:34:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=165577, encodeId=eaaa1655e786, content=癫痫持续状态,对大脑的神经损害,挺严重的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun Dec 25 12:32:47 CST 2016, time=2016-12-25, status=1, ipAttribution=)]
    2016-12-26 freve
  3. [GetPortalCommentsPageByObjectIdResponse(id=1999794, encodeId=61b11999e9404, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Jun 23 20:34:00 CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528334, encodeId=a71f1528334e4, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Mon Dec 26 06:34:00 CST 2016, time=2016-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=165577, encodeId=eaaa1655e786, content=癫痫持续状态,对大脑的神经损害,挺严重的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160313/IMG56E50DEC424F44672.jpg, createdBy=ce5b1699635, createdName=Lisa971, createdTime=Sun Dec 25 12:32:47 CST 2016, time=2016-12-25, status=1, ipAttribution=)]
    2016-12-25 Lisa971

    癫痫持续状态,对大脑的神经损害,挺严重的。

    0

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