CAJ | 학술논문

癫发作依据持续的时程和对治疗的反应分为早期癫持续状态( early status epilepticus)、确认的癫持续状态( established status epilepticus)、难治性癫持续状态( refractory status epilepticus)和超级难治性癫持续状态( super-refractory status epilepticus)。本研究主要针对难治性及超级难治性癫的治疗策略进行系统回顾，包括致病相关因素、脑损伤的分析，指出超级难治性癫是一个重要的临床问题，有着较高的病死率和发病率。现就近期世界范围发表的文献提出的治疗方法进行评价，包括麻醉药物，抗癫药物，镁剂，吡哆醇，类固醇和免疫治疗，生酮饮食，低温疗法，神经外科干预，经颅磁刺激，迷走神经刺激，脑深部刺激，电休克疗法，脑脊液引流及其他传统药物等疗法。强调原因的识别与对因治疗的重要性，推荐难治性癫分段治疗方案及超级难治性癫的管理流程。
전발작의거지속적시정화대치료적반응분위조기전지속상태( early status epilepticus)、학인적전지속상태( established status epilepticus)、난치성전지속상태( refractory status epilepticus)화초급난치성전지속상태( super-refractory status epilepticus)。본연구주요침대난치성급초급난치성전적치료책략진행계통회고，포괄치병상관인소、뇌손상적분석，지출초급난치성전시일개중요적림상문제，유착교고적병사솔화발병솔。현취근기세계범위발표적문헌제출적치료방법진행평개，포괄마취약물，항전약물，미제，필치순，류고순화면역치료，생동음식，저온요법，신경외과간예，경로자자격，미주신경자격，뇌심부자격，전휴극요법，뇌척액인류급기타전통약물등요법。강조원인적식별여대인치료적중요성，추천난치성전분단치료방안급초급난치성전적관리류정。
Status epilepticus basis for sustained duration and response to treatment can be divided into early status epilepticus,established status epilepticus,refractory status epilepticus and super-refractory status epilepticus. This article reviews the treatment approaches. Mainly conducted a systematic review for treatment strategy of refractory status epilepticus and super-refractory status epilepticus. Including pathogenic factors and cerebral damage analysis. It proposed super-refractory status epilepticus is an uncommon but important clinical problem with high mortality and morbidity rates. The published world literature on the following treatments is critically evaluated:anaesthetic a-gents,anti-epileptic drugs,magnesium infusion,pyridoxine,steroids and immunotherapy,ketogenic diet,hypothermia,e-mergency resective neurosurgery and multiple subpial transection,transcranial magnetic stimulation,vagal nerve stimula-tion,deep brain stimulation,electroconvulsive therapy,drainage of the cerebrospinal fluid and other older drug thera-pies. The importance of treating the identifying cause is stressed. And recommend protocols take a staged approach to treatment. A protocols and flowcharts for managing refractory status epilepticus and super-refractory status epilepticus are suggested.