本文選題：癲癇持續(xù)狀態(tài) + 預(yù)后��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究影響癲癇持續(xù)狀態(tài)預(yù)后的相關(guān)因素,提高臨床醫(yī)師對其認識,以期改善患者的預(yù)后。材料與方法回顧性分析2010年9月~2016年9月在寧夏醫(yī)科大學(xué)總醫(yī)院及心腦血管病醫(yī)院神經(jīng)內(nèi)科住院治療的癲癇持續(xù)狀態(tài)患者,收集其臨床資料,包括:年齡、性別、既往病史、病因、誘因、發(fā)作類型、腦電圖改變、顱腦CT、顱腦核磁、腦脊液改變及其他輔助檢查、并發(fā)癥及預(yù)后等,對上述資料進行整理歸納。用SPSS17.0軟件對相關(guān)數(shù)據(jù)進行統(tǒng)計分析,計數(shù)資料的比較采用卡方檢驗,取P0.05為差異具有統(tǒng)計學(xué)意義。用癲癇持續(xù)狀態(tài)嚴重評分量表(STESS)對患者的預(yù)后進行評估。結(jié)果1.共納入57例患者,53例好轉(zhuǎn),4例自動出院,電話隨訪得知4例自動出院者均死亡,SE病死率為7.02%。2.本研究中,以青年患者(14~44歲)最多(50.88%),而老年患者(≥65歲)病死率最高(37.5%)。3.SE發(fā)病原因中最常見的是急性腦血管病(17.54%),其次為顱內(nèi)感染(10.53%);發(fā)病誘因中最常見的是不規(guī)律服藥、自行減藥、停藥(15.79%)。4.SE患者住院期間最常見的并發(fā)癥為電解質(zhì)紊亂(61.40%),其次為感染(40.35%)、轉(zhuǎn)氨酶升高(29.82%)、呼吸抑制(12.28%)等。并發(fā)感染者最常見的是肺部感染(65.22%),其次為泌尿系感染(13.04%)。5.用單因素分析對相關(guān)變量進行統(tǒng)計學(xué)分析,得出:年齡、意識狀態(tài)及并發(fā)感染與預(yù)后(好轉(zhuǎn)/死亡)相關(guān)(P0.05)。將年齡、意識狀態(tài)、并發(fā)感染作為自變量,預(yù)后(好轉(zhuǎn)/死亡)作為因變量進行多因素Logistic回歸分析,得出P0.05。6.癲癇持續(xù)狀態(tài)嚴重評分量表評分為0~2分者45人,全部好轉(zhuǎn);評分為3~5分者12人,8人好轉(zhuǎn),4人死亡。不同評分的兩組患者預(yù)后有顯著性差異(P0.05)。結(jié)論1.年齡、意識狀態(tài)、感染與SE患者的預(yù)后相關(guān),超過65歲的老年人、意識狀態(tài)為昏睡或昏迷、合并感染者預(yù)后差。2.STESS量表可有效預(yù)測患者的預(yù)后。3.SE患者住院期間最常見的并發(fā)癥是電解質(zhì)紊亂,其次為感染(肺部感染最常見)、轉(zhuǎn)氨酶升高。
[Abstract]:Objective to study the related factors influencing the prognosis of epileptic status and to improve the prognosis of the patients. Materials and methods Epilepsy status patients who were hospitalized in the Department of Neurology, Ningxia Medical University General Hospital and Cardiovascular and Cerebrovascular Disease Hospital from September 2010 to September 2016 were retrospectively analyzed and their clinical data were collected, including age, sex, and past medical history. The causes, inducements, types of seizures, EEG changes, craniocerebral CTs, craniocerebral nuclear magnetic fields, cerebrospinal fluid changes and other auxiliary examinations, complications and prognosis were summarized. Using SPSS17.0 software to carry on the statistical analysis to the related data, the count data comparison uses the chi-square test, takes the P0.05 as the difference has the statistical significance. Epilepsy status severity scale (STESS) was used to evaluate the prognosis of the patients. Result 1. A total of 57 patients were included in this study. 53 patients were discharged automatically and 4 patients were discharged by telephone. The mortality rate of SE was 7.02%, and the mortality rate of SE was 7.02% (P < 0.05). In this study, the most common causes were young patients (aged 1444) and elderly patients (鈮，

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