CAJ | 학술논문

目的探讨儿童脑卒中后癫(癎)的临床特征、治疗及预后.方法回顾性分析2009年1月至2013年3月广东省人民医院儿科收治的69例脑卒中后癫(癎)患儿的病因、临床特征、辅助检查、治疗和预后资料.结果脑卒中后癫(癎)发生率为26.5％ (69/260例),男女发生率比较差异无统计学意义(x2=0.725,P=0.394),蛛网膜下腔出血患儿脑卒中后癫(癎)的发生率最高,为47.8％(11/23例),脑出血为34.6％(27/78例),脑缺血组最低为19.5％(31/159例),不同脑卒中类型的脑卒中后癫(癎)发生率比较差异有统计学意义(x2=12.000,P=0.02).早发性癫(癎)占76.8％(53/69例),迟发性癫(癎)占23.2％(16/69例),早发性癫(癎)多见于出血性脑卒中,迟发性癫(癎)多见于缺血性脑卒中,差异有统计学意义(x2 =4.778,P=0.029).早发性癫(癎)脑电图背景波普遍变慢.脑出血组以全面性发作为主,占70.4％(19/27例),脑缺血组以部分性发作为主,占54.8％(17/31例),蛛网膜下腔出血组90.9％(10/11例)为全面性发作,3组脑卒中后癫(癎)类型的分布比较差异有统计学意义(x2 =8.461,P=0.015).皮质病灶继发癫(癎)占77.6％(45/58例),皮质下病灶继发癫(癎)占22.4％(13/58例).对规律服用抗癫(癎)药物患儿随访6个月～4年,81.2％(56/69例)的患儿临床发作控制.结论儿童脑卒中后癫(癎)的发生率较成人高,多见于出血性脑卒中,尤以蛛网膜下腔出血的发生率最高,常规抗癫(癎)药物治疗有效.
목적 탐토인동뇌졸중후전(간)적림상특정、치료급예후.방법 회고성분석2009년1월지2013년3월광동성인민의원인과수치적69례뇌졸중후전(간)환인적병인、림상특정、보조검사、치료화예후자료.결과 뇌졸중후전(간)발생솔위26.5％ (69/260례),남녀발생솔비교차이무통계학의의(x2=0.725,P=0.394),주망막하강출혈환인뇌졸중후전(간)적발생솔최고,위47.8％(11/23례),뇌출혈위34.6％(27/78례),뇌결혈조최저위19.5％(31/159례),불동뇌졸중류형적뇌졸중후전(간)발생솔비교차이유통계학의의(x2=12.000,P=0.02).조발성전(간)점76.8％(53/69례),지발성전(간)점23.2％(16/69례),조발성전(간)다견우출혈성뇌졸중,지발성전(간)다견우결혈성뇌졸중,차이유통계학의의(x2 =4.778,P=0.029).조발성전(간)뇌전도배경파보편변만.뇌출혈조이전면성발작위주,점70.4％(19/27례),뇌결혈조이부분성발작위주,점54.8％(17/31례),주망막하강출혈조90.9％(10/11례)위전면성발작,3조뇌졸중후전(간)류형적분포비교차이유통계학의의(x2 =8.461,P=0.015).피질병조계발전(간)점77.6％(45/58례),피질하병조계발전(간)점22.4％(13/58례).대규률복용항전(간)약물환인수방6개월～4년,81.2％(56/69례)적환인림상발작공제.결론 인동뇌졸중후전(간)적발생솔교성인고,다견우출혈성뇌졸중,우이주망막하강출혈적발생솔최고,상규항전(간)약물치료유효.
Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 ％) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8％,11/23 cases),followed by those with cerebral hemorrhage (34.6％,27/78 cases),and lastly,those with cerebral ischemia (19.5％,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8％,53/69 cases),others in the late stage(23.2％,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 ＝ 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6％) suffered from cortical lesions and 13 of 58 patients (22.4％) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2％ (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.