持续脑功能监测在儿童癫痫持续性状态预后评估中的临床研究

Clinical Research on the Use of Continuous Cerebral Function Monitoring in the Prognosis Assessment of Children with Status Epilepticus

目的探讨持续脑功能监测在癫痫持续性状态患儿预后评估中应用效果。方法以2019年7月至2021年7月广西壮族自治区南溪山医院儿科儿童监护室(PICU)收治的63例癫痫持续状态(SE)患儿进行回顾分析,探讨持续脑功能监测在癫痫持续性状态患儿治疗情况以及对预后的影响。结果非惊厥性癫痫持续状态(NCSE)组咪达唑仑使用时间及入住PICU时间均比惊厥性癫痫持续状态(CSE)组明显延长。VEEG特征痫样放电:NCSE组的发生率较CSE组均显著升高。脑电图分级:CSE组较NCSE组在4~6级脑电的发生率具有显著差异,脑电图分级与脑功能早期预后呈明显正相关性。结论持续脑功能监测在SE患儿的临床治疗中具有重要价值,不仅能有效的发现和鉴别CSE和NCSE,对儿童SE进行更具体的分类和评估,还可以滴定和调整抗发作药物(ASM)临床治疗,并改善治疗效果。EEG分级在SE患儿预后的研究中能更客观地反映脑功能损伤的程度,可以作为治疗效果和脑功能预后的评估指标。

Objective To explore the effect of continuous brain function monitoring in the prognosis evaluation of children with persistent epilepsy.Methods A total of 63 children with status epilepticus(SE)admitted to the pediatric intensive care unit of Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2019 to July 2021 were retrospectively analyzed to explore the role of continuous brain function monitoring in children with status epilepticus.Treatment status and impact on prognosis.Results Midazolam use time and PICU admission time in NCSE group were significantly longer than those in CSE group,and both were significantly higher than those in CSE group.VEEG characteristic epileptiform discharge:The incidence of NCSE group was significantly higher than that of CSE group.EEG grading:The incidence of grade 4~6 EEG was significantly different in CSE group compared with NCSE group,and there was a significant positive correlation between EEG grading and early prognosis of brain function.Conclusions Continuous cerebral function monitoring is of great value in the clinical treatment of children with SE,which can not only effectively detect and differentiate CSE and NCSE,but also classify and evaluate children with SE,and titrate and adjust the clinical treatment of anti-seizure medication(ASM),and improve the therapeutic effect.EEG classification can more objectively reflect the degree of cerebral function damage in the prognosis of children with SE.EEG classification can more objectively reflect the degree of brain function damage in the study,and can be used as an assessment index for treatment effect and brain function prognosis.