【摘要】：目的分析老年自發(fā)性蛛網(wǎng)膜下腔出血(SAH)后癲癇發(fā)作危險(xiǎn)因素及臨床治療效果。方法老年SAH后癲癇發(fā)作患者42例為觀察組,同期老年SAH未發(fā)作癲癇45例為對(duì)照組,分析可能影響老年SAH后并發(fā)癲癇發(fā)作的相關(guān)因素及危險(xiǎn)因素。結(jié)果 SAH后癲癇發(fā)作以大發(fā)作為主,其次為精神運(yùn)動(dòng)性發(fā)作和小發(fā)作,發(fā)作時(shí)間集中在蛛網(wǎng)膜下腔出血后1 w內(nèi),其次為3 w及以上和1~3 w。相關(guān)因素分析顯示,性別、年齡、飲酒、出血后就診時(shí)收縮壓170 mm Hg、格拉斯哥昏迷評(píng)定(GCS)評(píng)分、Fisher評(píng)分、Rankin評(píng)分、出血后腦血管痙攣、再出血、腦積水、腦梗死與老年SAH后并發(fā)癲癇相關(guān)(P0.05)。多因素Logistic回歸分析顯示,腦梗死、Rankin 3~4分、再出血、Fisher 3~4評(píng)分是SAH后癲癇獨(dú)立危險(xiǎn)因素。經(jīng)托吡酯治療19例,經(jīng)丙戊酸鈉治療23例,1年內(nèi)兩種治療方法患者死亡率、癲癇發(fā)作率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。但托吡酯治療藥物不良反應(yīng)明顯低于丙戊酸鈉(P0.05)。結(jié)論老年SAH后癲癇發(fā)作的影響因素較多,獨(dú)立危險(xiǎn)因素與腦損傷相關(guān)。對(duì)于有相關(guān)影響因素和獨(dú)立危險(xiǎn)因素的患者,應(yīng)提早預(yù)防性應(yīng)用抗癲癇藥物,以期降低癲癇發(fā)作,在選擇抗癲癇藥物時(shí),應(yīng)充分考慮藥物副作用的影響。
[Abstract]:Objective to analyze the risk factors and clinical effect of epileptic seizures after (SAH) in elderly patients with spontaneous subarachnoid hemorrhage. Methods 42 elderly patients with epileptic seizures after SAH were selected as observation group and 45 patients with non-epileptic seizures in elderly SAH at the same time as control group. The related factors and risk factors of epileptic seizures after elderly SAH were analyzed. Results after SAH, the seizures were mainly large seizures, followed by psychomotor seizures and small seizures. The seizure time was concentrated within 1 week after subarachnoid hemorrhage, followed by 3 weeks and more and 1 鈮，

本文編號(hào)：2499177