脑电图监护对脑卒中后癫痫发作的诊治疗效及预后因素分析

Care for the diagnosis and treatment efficacy and prognostic factors of seizures after stroke analysis

目的 探讨脑电图监护对卒中后癫痫发作的诊治及预后效果。方法 纳入2013年1月至2017年11月本院重症监护病房脑卒中行脑电图(EEG)连续监测患者共568例,对纳入研究的患者进行为期1年的随访,了解脑趋势图改变与相应的癫痫发作关系,观察疗效和预后情况,对就诊、预后相关的影响因素进行Logistic回归分析。结果 568例重症监护的脑卒中后患者中89例发生了癫痫,42例保持癫痫持续状态;脑卒中后在早期出现癫痫发作的患者死亡率较高,控制脑卒中后癫痫的发作方面抗癫痫药物及镇静药物有效率达92.1%,应重视脑卒中后癫痫的早期发现和治疗。logistic回归分析发现,循环衰竭、心力衰竭、低蛋白血症、肝功能衰竭、胃肠损害、酸碱失衡及电解质紊乱、是否行无创呼吸机辅助通气与预后具有相关性。结论 脑卒中继发性早期癫痫患者预后较差,预后与循环衰竭、低蛋白血症、肝功能衰竭、心力衰竭、胃肠损害、电解质紊乱、酸碱失衡有相关性,积极控制癫痫的发作,能有效改善患者的预后。

Objective To investigate the diagnosis and treatment of post-stroke epilepsy and the prognostic effect of intensive care.Methods A total of 568 patients with continuous EEG monitoring were enrolled in the intensive care unit from January 2013 to November 2017.A follow-up study was conducted on the patients enrolled in the study.And the corresponding seizure relationship,observation of efficacy and prognosis of the treatment,prognostic factors related to logistic regression analysis.Results Of the 568 patients with severe stroke,89 patients had epilepsy and 42 had persistent epilepsy.The mortality rate of epilepsy was higher in the early stage after stroke,and the onset of epilepsy after stroke was higher Epilepsy drugs and sedative drug efficacy rate of 92.0%,should pay attention to post-stroke epilepsy early detection and treatment.Logistic regression analysis found that circulatory failure,heart failure,hypoproteinemia,liver failure,gastrointestinal damage,acid-base imbalance and electrolyte imbalance,whether non-invasive ventilator assisted ventilation and prognosis are related.Conclusion Stroke is one of the main causes of epileptic seizures.The prognosis of patients with secondary epilepsy is lower,the prognosis is associated with circulatory failure,hypoproteinemia,liver failure,heart failure,gastrointestinal damage,electrolyte imbalance,Acid-base imbalance is related,and actively control the onset of epilepsy,can effectively improve the prognosis of patients.