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小儿肾移植受者癫痫持续状态的诊断与治疗

Diagnosis and treatment of status epilepticus in a pediatric renal recipient.

作者信息

Hongjun Gao, Xiangdong Luo, Taisheng Liang, Shangguang Lu, Fangfang Liang, Yu Dong, Zhen Tan, Zhen Wu

机构信息

RuiKang Hospital, Affiliated to GuangXi Chinese Traditional Medicine College, Nanning 530011, China.

出版信息

Case Rep Transplant. 2011;2011:706107. doi: 10.1155/2011/706107. Epub 2012 Jan 5.

Abstract

We elaborate on the retrospective analysis of clinical data on a patient afflicted with grand mal seizures following a kidney transplant. The 16-year-old female patient was hospitalized for chronic glomerulonephritis. She experienced an epileptic seizure and was treated with carbamazepine. Renal transplantation was performed; the function of the transplant kidney was normal. However, grand mal seizures, which required intravenous and luminal intramuscular diazepam injections for control, began on the fourth postoperative day and lasted for 3 days, occurring approximately 10 to 20 times per day. On the sixth day, the patient fell into a deep comatose state and developed the inability to move the right side of her body, hypomyotonia, type 1 respiratory failure, and a pulmonary infection. She was given a breathing machine to assist with respiration. At the same time, she was given protection from infection, tranquilization, treatment for dehydration and diuresis, supportive therapy for the right side of her body, and adjustment of her immunosuppressants. On the 12th postoperative day, the patient's consciousness gradually returned; on the 15th day, the breathing machine was removed with recovery of myodynamia; on the 27th day, she was fully cured with no neurological sequelae.

摘要

我们详细阐述了对一名肾移植后发生癫痫大发作患者的临床数据进行的回顾性分析。该16岁女性患者因慢性肾小球肾炎住院。她经历了一次癫痫发作,并接受了卡马西平治疗。进行了肾移植;移植肾的功能正常。然而,癫痫大发作在术后第四天开始,持续了3天,每天大约发作10到20次,需要静脉注射和腔内肌肉注射地西泮来控制。在第六天,患者陷入深度昏迷状态,并出现右侧身体活动不能、肌张力减退、I型呼吸衰竭和肺部感染。给她使用了呼吸机辅助呼吸。同时,给予她抗感染、镇静、脱水利尿治疗、右侧身体的支持治疗以及免疫抑制剂的调整。术后第12天,患者意识逐渐恢复;第15天,撤掉呼吸机,肌力恢复;第27天,她完全治愈,无神经后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89c4/3504280/d518486906fe/CRIM.TRANSPLANTATION2011-706107.001.jpg

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