本文選題：睡眠中癲癇性電持續(xù)狀態(tài) + 睡眠��； 參考：《山東大學》2017年碩士論文

【摘要】：背景:非快速動眼睡眠期持續(xù)棘慢波發(fā)放占整個睡眠期50%以上即可診斷睡眠期癲癇性電持續(xù)狀態(tài)(ESES)。Landau-Kleffner綜合征、不典型兒童良性癲癇伴中央顳區(qū)棘波變異型、癲癇伴慢波睡眠期持續(xù)棘慢波等癲癇性腦病均可出現(xiàn),這種特殊的腦電活動可嚴重影響語言、認知、發(fā)育等功能。在ESES臨床治療中,會使用抗癲癇藥物(AEDs,antiepileptic drug)、促腎上腺皮質激素、靜脈注射丙種球蛋白(IVIG,intravenous immune globulin)、免疫治療、生酮飲食(KD,ketogenic diet)等治療方式,但療效均不顯著。作為多個同類研究和大量文獻綜合分析的重要方法,Meta分析是解決同一醫(yī)學問題多種研究報告的循證醫(yī)學手段,可以通過對研究結果進行系統(tǒng)的、定量的、綜合的統(tǒng)計分析,這樣不但能協(xié)助研究疾病的藥物治療,還對疾病的預防與篩查、流行病學研究等有重要指導意義。如果在臨床中能夠正確以及合理的應用Meta分析,可以為臨床工作和研究提供極大的幫助。目的:本研究旨在通過Meta分析,評估ESES各種治療方案的有效性,確定不同治療方案對ESES的治療價值,為臨床用藥提供理論依據(jù)。方法:通過Ebsco數(shù)據(jù)庫,Elsevier sciencedirect數(shù)據(jù)庫,Medline數(shù)據(jù)庫,Pubmeb數(shù)據(jù)庫,Web of science數(shù)據(jù)庫,相關期刊論文(CNKI)、維普數(shù)據(jù)庫(VIP)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)來進行文獻的檢索工作。合并各納入研究治療的有效率來實現(xiàn)對ESES疾病治療方法有效性的評定。文章中各研究間的異質性分析主要是通過Q檢驗以及I2統(tǒng)計量來表示,如果各個研究間的異質性比較大,則要采用隨機效應模型(random effects model,REM)合并其有效率,反之則采用固定效應模型(fixed effects model,FEM)來合并統(tǒng)計量。發(fā)表偏倚通過漏斗圖檢測,數(shù)據(jù)分析應用Stata 13.0來完成。結論:Meta分析結果顯示生酮飲食的臨床有效性最低,手術治療和抗癲癇藥物治療的臨床有效性相比,手術治療的有效性相對較高。
[Abstract]:Background: the non rapid eye sleep duration spinous wave is more than 50% of the whole sleep period, which can diagnose the epileptic electric persistent state (ESES).Landau-Kleffner syndrome in the sleep period, the atypical children with benign epilepsy with the central temporal spinous wave variant, and the epilepsy associated with the slow wave of the slow wave and other epileptic encephalopathy. EEG activity can seriously affect language, cognition, development and other functions. In ESES clinical treatment, antiepileptic drugs (AEDs, antiepileptic drug), adrenocorticotropin, intravenous immunoglobulin (IVIG, intravenous immune globulin), immunotherapy, and ketogenic diet (KD, ketogenic diet) are used, but the curative effect is not significant. As an important method of multiple research and comprehensive literature analysis, Meta analysis is an evidence-based medical method to solve the multiple research reports of the same medical problem. It can be systematically, quantified and comprehensive statistical analysis of the results of the study, so that it can not only help to study the drug treatment of the disease, but also prevent and screen the disease. Epidemiological studies, etc., have important guiding significance. If the Meta analysis can be applied correctly and reasonably in clinical practice, it can provide great help for clinical work and research. Objective: This study aims to evaluate the effectiveness of various treatments of ESES by Meta analysis and to determine the value of treatment for ESES by different treatments for clinical use. Provide theoretical basis. Methods: through the Ebsco database, the Elsevier ScienceDirect database, the Medline database, the Pubmeb database, the Web of science database, the Chinese periodical full text database (CNKI), the VP database (VIP), and the Chinese biomedical literature database (CBM) to carry out the retrieval work of the literature. To evaluate the effectiveness of the ESES disease treatment, the heterogeneity analysis in each study is mainly expressed by Q test and I2 statistics. If the heterogeneity of each study is relatively large, a random effect model (random effects model, REM) is used to be combined with its efficiency, and on the contrary, a fixed effect model (fixed) is used. Effects model, FEM) to merge the statistics. The publication bias was detected by the funnel map and the data analysis was performed with Stata 13. Conclusion: the results of Meta analysis showed that the clinical effectiveness of the ketogenic diet was the lowest, and the effectiveness of surgical treatment and antiepileptic drug treatment was relatively high.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R742.1

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本文編號：1929130