评估与接受 fenytoin 预防治疗的患者突破性早期创伤后发作相关的风险因素
Eugene Generoso1, Calvin Diep1, Carolyn Hua1
1Department of Pharmacy, Stanford Health Care, Palo Alto, CA, United States.
Frontiers in neurology
|January 19, 2024
概括
年龄较大,马歇尔分数较高和神经外科手术增加了在受伤性脑损伤 (TBI) 患者中突破性创伤后 (PTS) 的风险. 许多发作发生了尽管治疗费尼托因水平,表明潜在的预防差距.
科学领域:
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 创伤后 (PTS) 是创伤性脑损伤 (TBI) 后的一个重要并发症.
- 氨酸通常用于TBI患者的发作预防.
- 识别突破性发作的危险因素对于优化患者护理至关重要.
研究的目的:
- 为了确定与突破性早期创伤后发作 (PTS) 相关的风险因素,在受性脑损伤 (TBI) 患者中接受氨酸预防治疗.
- 分析早期PTS的发生率和相关的临床因素.
- 评估早期PTS对患者结局的影响.
主要方法:
- 进行了一项以单一为中心的回顾性研究.
- 包括患有TBI入院至ICU的成年患者,在24小时内接受类预防治疗.
- 主要结局:早期PTS的发病率和因素 (在连续EEG中在TBI后7天内发作).
主要成果:
- 分析了105名患者. 早期PTS患者年龄较大 (65岁与48岁相比),马歇尔分数较高 (5与2),神经外科手术较多 (57%与19%).
- 在患有早期PTS的患者中,57%的患者进行了氨酸水平绘制,其中87.5%的患者是治疗性的.
- 早期PTS与更长的ICU停留时间 (14.7 vs. 5.9天) 和更高的住院死亡率 (21% vs. 2%) 相关.
结论:
- 更高的年龄,马歇尔得分和神经外科手术程序与突破早期PTS有关,尽管类预防.
- 许多早期的PTS病例发生在治疗费尼托因水平上,这表明当前预防策略的潜在局限性.
- 需要进一步的研究来完善TBI患者的发作预防方案.
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