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定义新生儿状态:来自ILAE新生儿工作组的范围审查

Magda L Nunes¹, Elissa G Yozawitz², Courtney J Wusthoff³

¹School of Medicine and Brain Institute (BraIns), Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, Brazil.

|November 14, 2024

概括

新生儿发作的定义各不相同,大多数使用30分钟的标准. 然而,证据不足以证实这种持续时间会影响结果. 对于新生儿状态 (SE) 和负担,需要采用标准化的方法.

科学领域:

新生儿神经病学新生儿神经病学
发病学 (Epileptology) 是一个专业的学科.
临床神经生理学临床神经生理学

背景情况:

新生儿发作,特别是状态 (SE),是关键的神经紧急情况.
目前对新生儿发作负担的定义和评估缺乏标准化.
长时间的发作在成人和老年儿童中与不良结果有关,但这在新生儿中尚不清楚.

研究的目的:

对新生儿状态 (SE) 和/或负担的定义进行现有文献的范围审查.
分析用于识别和分类新生儿发作的方法.
识别定义中的变化及其对神经学结果的潜在影响.

主要方法:

国际反联盟新生儿工作组进行了系统的文献审查.
文章被选为新生儿SE和扣押负担的定义.
抽象的数据包括文章和队列特征,SE定义,以及发作识别方法 (EEG,cEEG,aEEG,临床特征).

主要成果:

44篇文章提供了新生儿SE的定义,主要是在患有缺氧缺血性脑病变或有发作风险的婴儿中.
连续EEG (cEEG) 是最常用的SE识别方法.
大多数定义依赖于发作的持续时间 (例如,≥50%的一个小时,>30分钟),有20项研究报告了发作负担,通常是总的EEG发作持续时间.

结论:

在文献中,新生儿SE的定义存在显著的异质性.
目前的定义,通常基于30分钟的持续时间,缺乏足够的证据来支持它们的临床相关性或与结果的关联.
新生儿特别工作组的目标是为定义新生儿SE和评估发作负担制定标准化框架.

关键词:

新生儿新生儿新生儿新生儿神经临床护理是指神经临床护理.结果结果结果结果.发作负担的增加发作发作这些状态性的状态

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