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一家儿科医院中迷走神经刺激器植入治疗癫痫:疗效及对生活质量的影响

Vagus nerve stimulator implantation for epilepsy in a paediatric hospital: outcomes and effect on quality of life.

作者信息

Ulate-Campos A, Cean-Cabrera L, Petanas-Argemi J, García-Fructuoso G, Aparicio J, López-Sala A, Palacio-Navarro A, Mas M J, Muchart J, Rebollo M, Sanmartí F X

机构信息

Unidad de Epilepsia, Servicio de Neurología y Neurocirugía, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.

Unidad de Epilepsia, Servicio de Neurología y Neurocirugía, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.

出版信息

Neurologia. 2015 Oct;30(8):465-71. doi: 10.1016/j.nrl.2014.04.014. Epub 2014 Jun 26.

Abstract

INTRODUCTION

Epilepsy, which is present in 0.5% to 1% of the paediatric population, is one of the most frequent childhood neurological disorders. Approximately 20% to 30% of these cases will be drug-resistant. The objective of this study is to describe the impact of vagal nerve stimulation (VNS) on seizures and quality of life in a sample of 30 patients.

METHODS

Descriptive, retrospective study of all patients with a VNS device implanted between 2008 and 2013 in a single paediatric hospital, based on patients' medical records. Quality of life was assessed using the Spanish scale for quality of life in children with epilepsy, completed by means of a telephone interview.

RESULTS

We describe a population of 19 boys (64%) and 11 girls (36%) with a mean age at seizure onset of 21 months (1-144 months). The mean age of VNS implantation was 11.89 years. Follow-up periods ranged from 6 to 36 months. Mean reduction in seizures at 6 months was 38%, with a reduction of 43% at 12 months, 42% at 24 months, and 54% at 36 months. At least half of all patients were classified as responders. According to the quality of life scale, 54% of the families rated the effect of VNS as either very good or good while 39% rated it as fair.

CONCLUSIONS

VNS is a safe palliative treatment that is generally well tolerated. It is partially effective for controlling drug-resistant epilepsy and exerts a positive effect on quality of life.

摘要

引言

癫痫在0.5%至1%的儿科人群中存在,是最常见的儿童神经系统疾病之一。这些病例中约20%至30%将对药物耐药。本研究的目的是描述迷走神经刺激(VNS)对30例患者样本中癫痫发作和生活质量的影响。

方法

基于患者病历,对2008年至2013年在一家儿科医院植入VNS装置的所有患者进行描述性回顾性研究。使用西班牙癫痫儿童生活质量量表通过电话访谈评估生活质量。

结果

我们描述了一组患者,其中19名男孩(64%)和11名女孩(36%),癫痫发作的平均起始年龄为21个月(1至144个月)。VNS植入的平均年龄为11.89岁。随访期为6至36个月。6个月时癫痫发作的平均减少率为38%,12个月时为43%,24个月时为42%,36个月时为54%。所有患者中至少一半被归类为反应者。根据生活质量量表,54%的家庭将VNS的效果评为非常好或好,而39%的家庭评为一般。

结论

VNS是一种安全且通常耐受性良好的姑息治疗方法。它在控制耐药性癫痫方面部分有效,并对生活质量产生积极影响。

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