中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2010年
2期
156-157
,共2页
癫痫持续状态%骨科手术
癲癇持續狀態%骨科手術
전간지속상태%골과수술
Status epilepticus%Orthopaedics operation
目的 探讨骨科术后发生癫痫持续状态(SE)的病因、临床表现及治疗方法,以提高对该病的诊治水平.方法 回顾性分析北京积水潭医院神经内科自2000年8月至2008年9月骨科术后发生SE的21例患者的临床资料,其中既往有癫痫病史5例、急性缺血性脑血管病4例、脂肪栓塞综合征3例、瘤栓塞1例、代谢性脑病4例、低血糖1例、糖尿病酮症酸中毒1例、慢性肾功能不全2例,骨科手术情况:股骨干骨折术后8例、股骨颈骨折行髋关节置换术后7例、肱骨骨折术后3例、腰椎骨巨细胞瘤术后1例、胸椎爆裂性骨折术后合并肋骨骨折1例、糖尿病足截肢术后1例.结果 21例患者中首选地西泮注射液控制SE 11例,其中9例有效控制了癫痫发作:首选丙戊酸钠注射液控制SE 10例,其中6例有效控制了癫痫发作.结论 骨科术后出现SE的患者,其病因是多方面的,应具体分析.在围手术期控制好内科情况是基础,可明显减少SE的发生率及死亡率.抗癫痫药物的选择应结合患者的年龄、内科情况及药物不良反应等综合分析.
目的 探討骨科術後髮生癲癇持續狀態(SE)的病因、臨床錶現及治療方法,以提高對該病的診治水平.方法 迴顧性分析北京積水潭醫院神經內科自2000年8月至2008年9月骨科術後髮生SE的21例患者的臨床資料,其中既往有癲癇病史5例、急性缺血性腦血管病4例、脂肪栓塞綜閤徵3例、瘤栓塞1例、代謝性腦病4例、低血糖1例、糖尿病酮癥痠中毒1例、慢性腎功能不全2例,骨科手術情況:股骨榦骨摺術後8例、股骨頸骨摺行髖關節置換術後7例、肱骨骨摺術後3例、腰椎骨巨細胞瘤術後1例、胸椎爆裂性骨摺術後閤併肋骨骨摺1例、糖尿病足截肢術後1例.結果 21例患者中首選地西泮註射液控製SE 11例,其中9例有效控製瞭癲癇髮作:首選丙戊痠鈉註射液控製SE 10例,其中6例有效控製瞭癲癇髮作.結論 骨科術後齣現SE的患者,其病因是多方麵的,應具體分析.在圍手術期控製好內科情況是基礎,可明顯減少SE的髮生率及死亡率.抗癲癇藥物的選擇應結閤患者的年齡、內科情況及藥物不良反應等綜閤分析.
목적 탐토골과술후발생전간지속상태(SE)적병인、림상표현급치료방법,이제고대해병적진치수평.방법 회고성분석북경적수담의원신경내과자2000년8월지2008년9월골과술후발생SE적21례환자적림상자료,기중기왕유전간병사5례、급성결혈성뇌혈관병4례、지방전새종합정3례、류전새1례、대사성뇌병4례、저혈당1례、당뇨병동증산중독1례、만성신공능불전2례,골과수술정황:고골간골절술후8례、고골경골절행관관절치환술후7례、굉골골절술후3례、요추골거세포류술후1례、흉추폭렬성골절술후합병륵골골절1례、당뇨병족절지술후1례.결과 21례환자중수선지서반주사액공제SE 11례,기중9례유효공제료전간발작:수선병무산납주사액공제SE 10례,기중6례유효공제료전간발작.결론 골과술후출현SE적환자,기병인시다방면적,응구체분석.재위수술기공제호내과정황시기출,가명현감소SE적발생솔급사망솔.항전간약물적선택응결합환자적년령、내과정황급약물불량반응등종합분석.
Objective To explore the etiology, clinical features and treatment of status epilepticus (SE) after orthopedic surgery and improve the diagnosis and treatment. Methods The data of 21 patients with SE after orthopedic surgery were retrospectively analyzed. Among these 21 patients, 5 with epilepsy before the orthopedic surgery, 4 with acute ischemic cerebrovascular diseases, 3 with fat embolism syndrome, 1 with tumor emboli, 4 with metabolic encephalopathy, 1 with hypoglycemia, 1 with diabetic ketoacidosis and 2 with chronic renal insufficiency were found. Orthopedic surgery was performed on these patients: fracture of the shaft of the femur was found in 8; hip arthroplasty was performed in 7 with fracture of femoral neck; fracture of the shaft of the humerus was noted in 3; giant cell tumors in the lumbar vertebra was found in 1; burst fracture in the thoracic vertebra was found in 1 and amputation was conducted in 1 with diabetic gangrene. Results Diazepam injection was employed to control the seizure in 11 patients with SE and 9 got good effect; valproate sodium injection was also used to control the seizure in 10 patients with SE and 6 showed good results. Conclusions Many reasons can result in the happening of SE after orthopedic surgery. The incidence and death rate of SE can be obviously decreased by good controlling the physical conditions in the perioperative period. The anti-epilepsy drugs should be chosen according to the age and physical conditions of the patient and the side effects of the anti-epilepsy drugs.
