癫痫持续状态的预后评估—附57例病例分析

发布时间：2018-05-27 16:26

  本文选题：癫痫持续状态 + 预后　； 参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的研究影响癫痫持续状态预后的相关因素,提高临床医师对其认识,以期改善患者的预后。材料与方法回顾性分析2010年9月~2016年9月在宁夏医科大学总医院及心脑血管病医院神经内科住院治疗的癫痫持续状态患者,收集其临床资料,包括:年龄、性别、既往病史、病因、诱因、发作类型、脑电图改变、颅脑CT、颅脑核磁、脑脊液改变及其他辅助检查、并发症及预后等,对上述资料进行整理归纳。用SPSS17.0软件对相关数据进行统计分析,计数资料的比较采用卡方检验,取P0.05为差异具有统计学意义。用癫痫持续状态严重评分量表(STESS)对患者的预后进行评估。结果1.共纳入57例患者,53例好转,4例自动出院,电话随访得知4例自动出院者均死亡,SE病死率为7.02%。2.本研究中,以青年患者(14~44岁)最多(50.88%),而老年患者(≥65岁)病死率最高(37.5%)。3.SE发病原因中最常见的是急性脑血管病(17.54%),其次为颅内感染(10.53%);发病诱因中最常见的是不规律服药、自行减药、停药(15.79%)。4.SE患者住院期间最常见的并发症为电解质紊乱(61.40%),其次为感染(40.35%)、转氨酶升高(29.82%)、呼吸抑制(12.28%)等。并发感染者最常见的是肺部感染(65.22%),其次为泌尿系感染(13.04%)。5.用单因素分析对相关变量进行统计学分析,得出:年龄、意识状态及并发感染与预后(好转/死亡)相关(P0.05)。将年龄、意识状态、并发感染作为自变量,预后(好转/死亡)作为因变量进行多因素Logistic回归分析,得出P0.05。6.癫痫持续状态严重评分量表评分为0~2分者45人,全部好转;评分为3~5分者12人,8人好转,4人死亡。不同评分的两组患者预后有显著性差异(P0.05)。结论1.年龄、意识状态、感染与SE患者的预后相关,超过65岁的老年人、意识状态为昏睡或昏迷、合并感染者预后差。2.STESS量表可有效预测患者的预后。3.SE患者住院期间最常见的并发症是电解质紊乱,其次为感染(肺部感染最常见)、转氨酶升高。
[Abstract]:Objective to study the related factors influencing the prognosis of epileptic status and to improve the prognosis of the patients. Materials and methods Epilepsy status patients who were hospitalized in the Department of Neurology, Ningxia Medical University General Hospital and Cardiovascular and Cerebrovascular Disease Hospital from September 2010 to September 2016 were retrospectively analyzed and their clinical data were collected, including age, sex, and past medical history. The causes, inducements, types of seizures, EEG changes, craniocerebral CTs, craniocerebral nuclear magnetic fields, cerebrospinal fluid changes and other auxiliary examinations, complications and prognosis were summarized. Using SPSS17.0 software to carry on the statistical analysis to the related data, the count data comparison uses the chi-square test, takes the P0.05 as the difference has the statistical significance. Epilepsy status severity scale (STESS) was used to evaluate the prognosis of the patients. Result 1. A total of 57 patients were included in this study. 53 patients were discharged automatically and 4 patients were discharged by telephone. The mortality rate of SE was 7.02%, and the mortality rate of SE was 7.02% (P < 0.05). In this study, the most common causes were young patients (aged 1444) and elderly patients (鈮，

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