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新生儿期惊厥的处理:欧洲观点。

Approach to seizures in the neonatal period: a European perspective.

机构信息

Division of Neonatology, University Hospital La Fe, Valencia, Spain.

出版信息

Acta Paediatr. 2010 Apr;99(4):497-501. doi: 10.1111/j.1651-2227.2009.01659.x. Epub 2010 Jan 5.

Abstract

UNLABELLED

In the neonatal period, seizures rank among the most common neurological symptoms, often indicating an underlying serious neurological condition. It is remarkable that although new tools have been incorporated into the diagnosis of neonatal seizures, there is no consensus about the therapeutic approach among different doctors and institutions. Hence, although phenobarbital is still considered the initial drug of choice, the protocols reported in the literature show a great variability in the approach to treatment of refractory seizures. We used a questionnaire to gain information regarding the treatment of seizures in the neonatal period in different European institutions.

CONCLUSION

We conclude that phenobarbital is still the initial drug of choice followed by benzodiazepines, except in preterm infants with a birth weight below 1800 g. In refractory seizures, the use of continuous lidocaine infusion is most common. Of note, clinical studies with newer drugs have been mostly performed in the United States but not in Europe.

摘要

目的

在新生儿期,癫痫发作是最常见的神经系统症状之一,通常表明存在潜在的严重神经系统疾病。值得注意的是,尽管已经将新工具纳入新生儿癫痫发作的诊断中,但不同医生和机构之间在治疗方法上仍未达成共识。因此,尽管苯巴比妥仍被认为是首选的初始药物,但文献中报道的方案在治疗难治性癫痫发作的方法上存在很大差异。我们使用问卷了解了不同欧洲机构在新生儿期癫痫治疗方面的信息。

结论

我们的结论是,苯巴比妥仍然是首选药物,其次是苯二氮䓬类药物,但出生体重低于 1800 克的早产儿除外。在难治性癫痫发作中,最常使用持续利多卡因输注。值得注意的是,使用更新药物的临床研究主要在美国进行,而不是在欧洲进行。

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