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日本关于治疗儿科状态的指南 - 2023年
Kenjiro Kikuchi1, Ichiro Kuki2, Masahiro Nishiyama3
1Working Group for the Revision of Treatment Guidelines for Pediatric Status Epilepticus/Convulsive Status Epilepticus, Japanese Society of Child Neurology, Tokyo, Japan; Division of Neurology, Pediatric Epilepsy Center, Saitama Children 's Medical Center, Saitama, Japan.
Brain & development
|December 3, 2024
概括
更新的日本指南建议口服米达佐拉姆用于医院前和医院内儿科状态 (SE) 治疗. 如果可能的话,可以选择静脉注射的二,而洛拉泽巴姆的呼吸问题比迪亚泽巴姆少.
科学领域:
- 神经学 神经学
- 儿科症 儿科症
- 临床指南 临床指南
背景情况:
- 2015年国际抗联盟对 status epilepticus (SE) 的定义强调了早期治疗.
- 在日本,关于为儿科SE选择合适的药物仍然存在临床挑战.
- 一份修订后的指导方针"日本治疗儿科状态症指导方针2023" (GL2023) 解决了这些问题.
研究的目的:
- 为日本儿童状态的治疗提供最新的建议.
- 澄清用于SE的医院前和医院内治疗的药物选择.
- 为解决儿科SE治疗中的新出现的临床问题.
主要方法:
- 对儿科SE的当前证据和临床实践的审查和综合.
- 为药物选择和治疗策略制定基于证据的建议.
- 包括针对不同治疗环境 (医院前,医院内,已建立的SE) 的具体建议.
主要成果:
- 布卡尔米达佐拉姆 (bucal midazolam) 推用于医院前治疗以及当静脉注射无法在医院内获得时.
- 如果可以获得静脉注射,建议静脉注射类药物 (midazolam,lorazepam,diazepam).
- 洛拉泽巴姆与迪亚泽巴姆相比,呼吸系统抑郁的发病率较低,停止率相似.
- 类/类和类是已建立的儿科SE的选择;在日本, levetiracetam仅限于成年人.
- 对于耐火性SE,建议进行昏迷治疗,但对于超耐火性SE,不建议进行特定的治疗.
- 该指南承认对儿童非性SE (NCSE) 缺乏建议.
结论:
- GL2023提供了日本儿科SE治疗的最新指南,优先考虑口腔米达佐拉姆和静脉注射二.
- 这些指导方针强调了不同二胺的比较安全性概况.
- 需要进一步的研究,以建立有效的治疗方法和改善儿科非性SE的结果.
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