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脑肿瘤患者癫痫发作的管理。

The management of seizures in brain tumor patients.

机构信息

Neurosurgery Department, Northwestern Medical Faculty Foundation/Northwestern Memorial Hospital, Chicago, IL USA.

出版信息

J Neurosci Nurs. 2010 Feb;42(1):28-37; quiz 38-9. doi: 10.1097/jnn.0b013e3181c1fd83.

Abstract

The diagnosis of a brain tumor requires healthcare providers to examine the best course of treatment for each individual patient. Unfortunately, seizures are a common occurrence in those with brain tumors. Seizures can contribute to many undesirable life-altering consequences that can greatly impact quality of life. Healthcare providers are inconsistent in the use of prophylactic antiepileptic drugs. Despite published guidelines, prophylactic use of antiepileptic drugs is still practiced for patients who have never experienced a seizure. Because of the many side effects of first-generation antiepileptic drugs, this practice should be discouraged. Furthermore, drug interactions between antiepileptic drugs and antineoplastic treatments can cause life-threatening complications. Since the 1990s, newer antiepileptic drugs, which have fewer drug interactions, have been introduced and show promise as first-line therapy and adjunct treatment of epilepsy. Although reports have demonstrated their promise, prospective randomized controlled trials are needed to determine their reliability in this population of patients. Managing seizures in brain tumor patients requires diligent comprehensive care by healthcare providers to help limit unnecessary side effects and improve quality of life.

摘要

脑肿瘤的诊断需要医疗保健提供者为每个个体患者检查最佳的治疗方案。不幸的是,脑瘤患者常发生癫痫。癫痫发作会导致许多不良的改变生活的后果,极大地影响生活质量。医疗保健提供者在预防性使用抗癫痫药物方面不一致。尽管有发表的指南,但对于从未经历过癫痫发作的患者,仍在使用预防性抗癫痫药物。由于第一代抗癫痫药物有许多副作用,这种做法应予以劝阻。此外,抗癫痫药物与抗肿瘤治疗之间的药物相互作用可能会导致危及生命的并发症。自 20 世纪 90 年代以来,已经引入了具有较少药物相互作用的新型抗癫痫药物,它们作为一线治疗和癫痫的辅助治疗具有前景。尽管已有报告证明了它们的前景,但仍需要前瞻性随机对照试验来确定它们在这一患者群体中的可靠性。脑肿瘤患者的癫痫发作管理需要医疗保健提供者进行认真的全面护理,以帮助限制不必要的副作用并提高生活质量。

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