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关于德雷维特综合征的两种观点:临床医生和护理人员的观点。

Two Perspectives on Dravet Syndrome: Viewpoints from the Clinician and the Caregiver.

作者信息

Bluvstein Judith, Wenniger Susanna

机构信息

School of Medicine, Hofstra/Northwell, and Lennox Hill Hospital, Northwell Health, New York, NY, USA.

School of Medicine, Hofstra/Northwell, and Lennox Hill Hospital, Northwell Health, Brooklyn, NY, USA.

出版信息

Neurol Ther. 2023 Apr;12(2):343-350. doi: 10.1007/s40120-023-00450-3. Epub 2023 Feb 16.

Abstract

Dravet syndrome (DS) is a severe genetic epilepsy characterized by early-life onset, seizures, and neurodevelopmental delays that have major impacts on affected children. DS is an incurable condition that requires a lifelong multidisciplinary approach involving both clinical and caregiver support. A better understanding of the multiple perspectives involved in the care of patients is necessary for supporting the diagnosis, management, and treatment of DS. Here we describe the personal experiences of a caregiver and a clinician facing the challenges of diagnosing and treating a patient throughout the three phases of DS. During the initial phase, the main goals include establishing an accurate diagnosis, coordination of care, and communication between clinicians and caregivers. After a diagnosis is established, frequent seizures and developmental delays are a major concern in the second phase, which is very taxing on children and their caregivers, so caregivers require support and resources to advocate for safe and effective care. Seizures may improve in the third phase, but developmental, communication, and behavioral symptoms persist as caregivers navigate the eventual transition from pediatric to adult care. Optimal care for patients is provided when clinicians are well educated on the syndrome and collaboration is established between members of the medical team and family.

摘要

德雷维特综合征(DS)是一种严重的遗传性癫痫,其特征为发病早、癫痫发作以及神经发育迟缓,对患病儿童有重大影响。DS是一种无法治愈的疾病,需要终身采取多学科方法,包括临床支持和照顾者支持。为支持DS的诊断、管理和治疗,有必要更好地理解患者护理中涉及的多个方面。在此,我们描述了一位照顾者和一位临床医生在DS的三个阶段中面对诊断和治疗患者挑战的个人经历。在初始阶段,主要目标包括进行准确诊断、协调护理以及临床医生与照顾者之间的沟通。确诊后,频繁发作和发育迟缓是第二阶段的主要问题,这对儿童及其照顾者造成极大负担,因此照顾者需要支持和资源来争取安全有效的护理。在第三阶段,癫痫发作可能会改善,但随着照顾者应对患者最终从儿科护理向成人护理的过渡,发育、沟通和行为症状仍然存在。当临床医生对该综合征有充分了解,且医疗团队成员与家庭之间建立协作时,就能为患者提供最佳护理。

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