预防性强化抗癫痫治疗对院外心脏骤停患者预后的影响
Effect of prophylactic antiepileptic treatment on the prognosis of out-of-hospital cardiac arrest patients
孟玲 1刘莎莎1
作者信息
- 1. 邯郸市中心医院急诊内2科(河北邯郸,056001)
- 折叠
摘要
目的:探索预防性使用抗癫痫药物治疗节律性和周期性脑电图模式能否改善心脏骤停昏迷患者出院后3个月神经系统结局.方法:选取邯郸市中心医院急诊科EICU 2021年12月-2023年9月心脏骤停昏迷患者218例(GCS≤8分),1∶1随机分配为标准治疗组和强化抗癫痫治疗组,在自主循环恢复24 h内开始连续脑电监测.标准治疗组给予规范化治疗,强化抗癫痫治疗组在此基础上,在脑电图出现节律性和周期性脑电图模式3 h内,采用升阶梯预防性抗癫痫策略至少48 h.观察幸存患者出院后3个月临床结局.结果:标准治疗组3个月神经系统预后不良(CPC≥3分)发生率为89.9％,强化抗癫痫治疗组为78.9％,差异有统计学意义(P=0.0251).两组EICU住院时间和机械通气时间比较,强化抗癫痫治疗组略长于标准治疗组,差异无统计学意义(P＞0.05).结论:预防性使用抗癫痫药物治疗节律性和周期性脑电图模式能够改善心脏骤停昏迷幸存患者出院后3个月神经系统结局.
Abstract
Objective:To explore the preventive use of antiepileptic drugs to treat rhythmic and periodic elec-troencephalography(EEG)patterns to improve the ending of the nervous system for 3 months after out-of-hospital cardiac arrest(OHCA).Methods:Select 218 OHCA patients(GCS ≤8)from December 2021 to September 2023 in EICU of Handan Middle hospital.1∶1 randomly allocated as standard therapy group and antiepileptic therapy group.Within 24 h of return of spontaneous circulation,continuous EEG monitoring will be applied.The stand-ard treatment group is given standardized treatment,while antiepileptic therapy group start elevation ladder pre-vention of anti-epilepsy within 3 h rhythmic and periodic EEG patterns appeared at least for 48 h.Observe the clinical ending of the survivors 3 months after discharge.Results:The incidence of poor prognosis(CPC≥ 3)in the standard treatment group was 89.9％,and the antiepileptic treatment group was 78.9％,the difference was sta-tistically significant(P=0.0251).The EICU hospitalization and mechanical ventilation time of the anti-epilepsy treatment group were slightly longer than the standard treatment group,but the difference was not statistically significant(P＞0.05).Conclusion:Preventive use of antiepileptic drugs to treat rhythmic and periodic EEG pat-terns can improve the end of the nervous system for 3 months after out-of-hospital cardiac arrest.
关键词
院外心脏骤停/缺氧缺血性脑损伤/脑电图/抗癫痫Key words
out-of-hospital cardiac arrest/hypoxic-ischaemic brain injury/electroencephalography/epilepsy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据