在成年人手术后开始抗发作药物取消的时间
Carolina Ferreira-Atuesta1,2, Jane De Tisi2, Andrew William Mcevoy2,3
1Department of Neurology, Clinical Neuroscience Center, University Hospital & University of Zurich, Switzerland.
Neurology
|January 27, 2026
概括
在手术后两年内取消抗发作药物 (ASM) 会增加最初发作复发的风险. 然而,等待超过两年的时间对控制发作没有额外的好处,长期的结果仍然相似.
科学领域:
- 神经学 神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 临床结果研究研究
背景情况:
- 手术可以导致自由,促使考虑抗药物 (ASM) 停用.
- 目前的ASM手术后停药时间的做法是不一致的.
- 启动ASM退出以最大限度地降低发作复发风险的最佳时间尚未确定.
研究的目的:
- 为了比较发作复发的风险在个人开始抗发作药物 (ASM) 撤销在手术后的不同时间点.
- 在成功的手术后,为优化ASM戒断协议提供基于证据的见解.
主要方法:
- 一项多中心观察队列研究,涉及接受切除手术的成年人.
- 纳入标准:退出之前的无扣押状态和至少一年的随访.
- 倾向性得分匹配被用来比较在1,2,3,4或5年术后取消ASM的组之间的发作复发风险.
主要成果:
- 在手术后的头两年内启动ASM戒断与较晚戒断相比,复发的风险明显更高.
- 在手术后的第三年,第四年或第五年开始戒药时,没有观察到发作复发的风险增加.
- 长期无和完全停止ASM并没有受到药物停用时间的显著影响.
结论:
- 早期ASM退出 (在2年内) 后手术与增加初始复发风险有关.
- 延迟ASM退出超过两年似乎不会在减少发作风险方面带来额外的好处.
- 患者,护理人员和临床医生之间的共同决策至关重要,平衡ASM戒断的风险,益处和个人情况.
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