患有发作的儿童的手术:系统性审查和元分析,重点关注预测因素和结果
Taylor Kolosky1, Andrea Goldstein Shipper2, Kai Sun3
1University of Maryland School of Medicine, Baltimore, Maryland, USA.
Epilepsia open
|July 2, 2024
概括
针对发作 (ES) 的儿科手术为大多数儿童提供了显著的自由. 早期,像半球切除术这样的广泛切除可以改善结果并降低复发风险.
科学领域:
- 儿科神经学 儿科神经学
- 神经外科 神经外科
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 儿童的发作 (ES) 往往具有耐治疗性挑战.
- 切除性手术是儿科ES的潜在治疗选择.
- 了解手术结果和预测因素对于临床决策至关重要.
研究的目的:
- 系统地审查关于儿科ES切除手术后结局率的文献.
- 为了确定有利的发作结果的预后指标.
- 评估手术方法和持续时间对复发的影响.
主要方法:
- 在PubMed,EMBASE和Cochrane CENTRAL (1985年以来) 的系统文献搜索.
- 遵守系统审查和元分析 (PRISMA) 标准的优先报告项目.
- 对发作自由率的元分析和对预后因素的学科层面分析.
主要成果:
- 在21项研究中,合并的发作自由率为68.8% (n=531).
- 的持续时间增加 (每年7%) 和非半球切除切除 (57%的复发风险增加) 与更高的复发率有关.
- 与其他切除术相比,半球切除术显示发作复发的风险较低.
结论:
- 切除性手术对大多数患有ES的儿科患者有效地实现了无发作.
- 半球切除术与发作复发的风险较低有关.
- 手术前的较短持续时间和更广泛的切除预测了更好的长期控制.
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