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目的观察老年惊厥性癫痫持续状态(CSE)的临床特点。方法收集神经重症监护室(NICU)年龄≥60岁的CSE患者28例,回顾性分析其临床特点。结果脑血管病为28例老年CSE的首位病因。接受抗癫痫药物治疗后,CSE症状控制的中位时间为0.9 h,其中16例患者在1 h内症状控制,12例为难治性癫痫持续状态(RSE)。28例患者中,存活16例、死亡12例。死亡者与存活者相比,合并中枢神经系统新发疾病(P=0.027)和RSE的比例显著不同(P=0.027)。结论老年CSE患者基础情况差,病因多样,合并有中枢神经系统新发疾病或有RSE者的死亡率高。
Objective To observe the clinical features of senile convulsive status epilepticus (CSE). Methods Twenty-eight CSE patients aged ≥60 years were collected from NICU. The clinical features of the patients were retrospectively analyzed. Results Cerebrovascular disease was the first cause of 28 elderly CSE. After receiving antiepileptic drugs, the median time to symptom control for CSE was 0.9 h, of which 16 were symptomatic within 1 h and 12 were refractory status epilepticus (RSE). Of the 28 patients, 16 survived and 12 died. Compared with survivors, the proportion of newly diagnosed CNS disorders (P = 0.027) and RSE was significantly different between those who died and those who survived (P = 0.027). Conclusions Elderly patients with CSE have poor basic conditions and diverse causes. Those with new CNS diseases or those with RSE have a high mortality rate.