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[当前护理指南更新。癫痫持续状态的治疗]

[Update on current care guidelines. The treatment of status epilepticus].

作者信息

Kälviäinen Reetta, Eriksson Kai, Häppölä Olli, Keränen Tapani, Kurola Juoni, Kuusela Anna-Leena, Laukkala Tanja, Ruokonen Esko, Salmi Tapani, Hirsso Päivi, Kotila Matti

出版信息

Duodecim. 2009;125(22):2469-71.

Abstract

Status epilepticus is a medical emergency. Most epileptic seizures last for 1-4 minutes and seizures lasting over five minutes, should be treated as status epilepticus. EEG is essential for diagnostics and the monitoring of treatment effect. The treatment for status epilepticus, irrespective of aetiology, can be divided into first-aid medications, such as buccal midazolam or rectal diazepam, first-line medications such as intravenous diazepam or lorazepam, and second-line medications such as fosphenytoin and valproate for adults and phenobarbital for children. Third-line treatment is suppressive general anaesthesia, monitored by continuous EEG. Antiepileptic medication of patients with epilepsy should be carefully re-evaluated after episode of status epilepticus.

摘要

癫痫持续状态是一种医疗急症。大多数癫痫发作持续1 - 4分钟,持续超过五分钟的发作应被视为癫痫持续状态。脑电图对于诊断和治疗效果监测至关重要。癫痫持续状态的治疗,无论病因如何,可分为急救药物,如口腔咪达唑仑或直肠地西泮;一线药物,如静脉注射地西泮或劳拉西泮;以及二线药物,如成人用磷苯妥英和丙戊酸盐,儿童用苯巴比妥。三线治疗是在持续脑电图监测下的抑制性全身麻醉。癫痫患者在癫痫持续状态发作后应仔细重新评估抗癫痫药物治疗。

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