经手术后的急性发作是否预测了手术的结果? 一个范围审查审查
Sebastiaan E A van Maanen1, Maeike J M Zijlmans2, Pieter van Eijsden2
1Department of Neurology and Neurosurgery, Utrecht Brain Center, University Medical Center Utrecht, 3584CX, Utrecht, Netherlands. s.e.a.vanmaanen@umcutrecht.nl.
Acta neurochirurgica
|March 13, 2025
概括
早期将急性术后 (APOS) 分为下行 (RDS) 或上行 (RUS) 类型可以指导治疗. 诸如发作和发作频率等关键因素会影响结果,但需要更多的研究才能准确预测.
科学领域:
- 神经学 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:
- 急性术后发作 (APOS) 在手术后很常见.
- 随着时间的推移,APOS可以被归类为下行 (RDS) 或上行 (RUS) 发作.
- 早期区分RDS/RUS可以优化抗发作药物和手术决策.
研究的目的:
- 对影响APOS向RDS或RUS演变的变量进行文献审查.
- 为了确定与长期发作结果相关的因素,在切除性手术后.
主要方法:
- 系统地搜索PubMed和Embase的数据库,寻找有关运行现象和术后发作的研究.
- 纳入标准要求对APOS有明确的定义,并排除了高级恶性瘤.
- 对21项涉及1496名患者的研究进行了分析,研究了与长期发作结果相关的变量.
主要成果:
- 间接性发性泄漏的存在/侧面性,发性区域的大小,APOS频率,以及GTCS,头部创伤或脑炎的病史与发作结局有关.
- 的表达和发作复发的时间显示不那么重要.
- 由于结果矛盾,样本规模小,研究异质性等原因,关联是不确定的.
结论:
- 在APOS结果的变化需要一个精细的分类系统.
- 未来的研究应该开发和验证结果的多因素预测模型.
- 整合EEG,APOS频率和病史对于准确的预测至关重要.
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