發(fā)布時間：2018-04-16 10:24

  本文選題：老年 + 癲癇�。� 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究老年性癲癇的病因、臨床表現(xiàn)、輔助檢查、治療及預(yù)后。方法以“癲癇”和/或“發(fā)作”為檢索詞,從重慶醫(yī)科大學(xué)附屬第一醫(yī)院病案室調(diào)取2011年7月到2017年2月住院病人中出院診斷包含“癲癇”或/和“發(fā)作”字樣的患者信息,篩選出年齡≥60歲的患者,詳細(xì)分析所篩選的老年性癲癇患者的病歷資料,包括基本資料(姓名、性別、年齡、住院科室)、病因、臨床表現(xiàn)、輔助檢查(包括腦電圖、頭顱CT/MRI、生化檢查)、用藥,長期住院患者通過仔細(xì)閱讀病歷資料分析藥物療效及副反應(yīng),其余患者通過電話隨訪進(jìn)行記錄。結(jié)果96例(79.34%)有明確病因,常見病因包括腦血管疾病(59.38%),顱內(nèi)腫瘤(13.54%),中樞神經(jīng)系統(tǒng)感染(8.33%),腦外傷(5.20%),急性代謝或毒性因素(11.46%)。部分性發(fā)作71例(58.68%),其中復(fù)雜部分性發(fā)作54例(44.63%);全面強(qiáng)直-陣攣發(fā)作15例(12.40%);強(qiáng)直性發(fā)作14例(11.57%);癲癇持續(xù)狀態(tài)17例(14.05%);不典型發(fā)作4例(3.31%)。丙戊酸鈉、左乙拉西坦是最常用的藥物。82例患者治療有效(97.62%),88.10%患者僅單藥治療即有效。結(jié)論老年性癲癇大多存在明確病因,其中腦血管疾病最常見,顱內(nèi)腫瘤、中樞神經(jīng)系統(tǒng)感染、腦外傷為常見病因,急性代謝或毒性因素不容被忽視。部分性發(fā)作為最常見的發(fā)作類型,尤其以復(fù)雜部分性發(fā)作最多見。多數(shù)患者僅使用單藥治療可以減少癲癇發(fā)作,僅少部分患者需要兩種或兩種以上藥物聯(lián)合治療。
[Abstract]:Objective to study the etiology, clinical manifestation, adjuvant examination, treatment and prognosis of senile epilepsy.Methods using "epilepsy" and / or "seizure" as the key words, the information of the patients who had been discharged from the first affiliated Hospital of Chongqing Medical University from July 2011 to February 2017 to diagnose the patients with the words "epilepsy" or / and "seizure" were collected from the medical records room of the first affiliated Hospital of Chongqing Medical University.Patients aged more than 60 years were selected. The medical records of the selected patients with senile epilepsy were analyzed in detail, including basic data (name, sex, age, hospitalization, etiology, clinical manifestations, auxiliary examinations (including electroencephalogram, EEG).CTR / MRI, biochemical examination, medication, long-term inpatients through careful reading of medical records analysis of drug efficacy and side effects, the rest of the patients were recorded by telephone follow-up.Results 96 cases (79.34) had definite etiology. The common causes included cerebrovascular disease (59.38), intracranial tumor (13.54), central nervous system infection (8.33%), brain injury (5.20%), acute metabolic or toxic factors (11.46%).There were 71 cases of partial seizure, 54 cases of complex partial seizure, 15 cases of total tonic-clonic seizure, 14 cases of tonic seizure, 14 cases of tonic attack, 17 cases of epileptic status and 14.05%, 4 cases of atypical seizure, and 3.31% of the total tonic-clonic seizure.Valproate sodium, levoethylacetam is the most commonly used drug. 82 patients with effective treatment of 97.62% of the patients with 88.10% of the drug alone is effective.Conclusion the most common causes of senile epilepsy are cerebrovascular diseases, intracranial tumors, central nervous system infection and brain trauma. The acute metabolic or toxic factors should not be ignored.Partial onset is the most common type of attack, especially complex partial attack.Only a few patients need two or more drugs to treat epilepsy.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R742.1

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本文編號：1758489