摘要
癫发作依据持续的时程和对治疗的反应分为早期癫持续状态（ early status epilepticus）、确认的癫持续状态（ established status epilepticus）、难治性癫持续状态（ refractory status epilepticus）和超级难治性癫持续状态（ super-refractory status epilepticus）。本研究主要针对难治性及超级难治性癫的治疗策略进行系统回顾，包括致病相关因素、脑损伤的分析，指出超级难治性癫是一个重要的临床问题，有着较高的病死率和发病率。现就近期世界范围发表的文献提出的治疗方法进行评价，包括麻醉药物，抗癫药物，镁剂，吡哆醇，类固醇和免疫治疗，生酮饮食，低温疗法，神经外科干预，经颅磁刺激，迷走神经刺激，脑深部刺激，电休克疗法，脑脊液引流及其他传统药物等疗法。强调原因的识别与对因治疗的重要性，推荐难治性癫分段治疗方案及超级难治性癫的管理流程。
Status epilepticus basis for sustained duration and response to treatment can be divided into early status epilepticus,established status epilepticus,refractory status epilepticus and super-refractory status epilepticus. This article reviews the treatment approaches. Mainly conducted a systematic review for treatment strategy of refractory status epilepticus and super-refractory status epilepticus. Including pathogenic factors and cerebral damage analysis. It proposed super-refractory status epilepticus is an uncommon but important clinical problem with high mortality and morbidity rates. The published world literature on the following treatments is critically evaluated：anaesthetic a-gents,anti-epileptic drugs,magnesium infusion,pyridoxine,steroids and immunotherapy,ketogenic diet,hypothermia,e-mergency resective neurosurgery and multiple subpial transection,transcranial magnetic stimulation,vagal nerve stimula-tion,deep brain stimulation,electroconvulsive therapy,drainage of the cerebrospinal fluid and other older drug thera-pies. The importance of treating the identifying cause is stressed. And recommend protocols take a staged approach to treatment. A protocols and flowcharts for managing refractory status epilepticus and super-refractory status epilepticus are suggested.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2015年第18期1371-1378,共8页
Chinese Journal of Applied Clinical Pediatrics
关键词
癫
难治性/超级难治性
治疗策略
Epilepticus
Refractory/super-refractory
Treatment strategy
