在 status epilepticus 中分阶段的治疗反应:来自 SENSE 注册表的教训
Isabelle Beuchat1, Jan Novy1, Felix Rosenow2,3
1Department of Neurology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.
Epilepsia
|November 1, 2023
概括
在第二步后,状态 (SE) 治疗的成功率下降. 耐火性SE (RSE) 仍然可以在约三分之一的患者中治疗,强调对积极治疗的临床判断.
科学领域:
- 神经学 神经学
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 随着每一次治疗失败,发作自由的可能性都在下降.
- 有限的数据存在于治疗疗效在状态 (SE) 的连续步骤.
研究的目的:
- 为了评估SE停止率和连续处理步骤后的功能结果.
- 调查治疗步骤对SE预后的影响.
主要方法:
- 对前性,观察性,多中心的SENSE队列进行了后期分析.
- 包括996个成年SE发作在第三阶段之前在没有昏迷诱导的情况下接受治疗.
- 在每个治疗步骤后评估SE停止,死亡率和功能结果 (修改的兰金表).
主要成果:
- 84.1%的SE发作得到了成功的治疗.
- 在第二个治疗阶段后,SE停止,生存和良好的功能结果显著下降.
- 耐火性SE (RSE),需要>2个步骤,发生在54.2%的患者中.
结论:
- 在第二个SE治疗阶段后,预后明显恶化,支持RSE的概念.
- 大约三分之一的RSE患者即使经过多个失败的步骤,仍然可以治疗.
- 临床判断对于确定SE治疗的积极性和持续时间至关重要,以避免过早停止治疗.
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