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神经疾病

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ACEP对成人癫痫患者处理的新要求
原作者: Andrea Tenner,于露 译 陈 发布日期:2014-07-09

 

Title: ACEP clinical policy update on the Management of Adult Patients Presenting with Seizures
标题:ACEP对成人癫痫患者处理的新要求
Author作者: Andrea Tenner
于露 译 陈都 肖锋 校

 

Background Information:
背景信息:
ACEP has recently revised its 2004 policy on critical issues in the evaluation and management of adult patients with seizures in the emergency department.
ACEP最近修改了2004年对急诊科成人癫痫患者相关重要问题的评估和处理。
Pertinent Study Design and Conclusions:
相关的研究设计和结论如下:
1. A literature review was conducted to derive evidence-based recommendations to help clinicians answer 4 critical questions. Only recomendations relating to question number 4 are presented in this pearl.
通过文献综述提出以循证为基础的建议,以帮助临床医生回答4个关键问题。本必知只报告对这4个关键问题相关的建议。
2. Evidence suggests that in cases refractory to benzodiazepine, valproate works as well as phenytoin and fosphenytoin in status epilepticus as a second-line agent. Compared to phenytoin or fosphenytoin, valproate can be given more quickly and has fewer adverse effects (Level B recommendation).
证据表明:在癫痫难治案例中,苯二氮卓类、丙戊酸钠和苯妥英、磷苯妥英同样起作用。苯妥英、磷苯妥英相比丙戊酸钠起效更快,副作用更小(B级推荐)。
3. This recommendation is intended for adult patients aged 18 years and older presenting to the ED with generalized convulsive seizures.
本建议适用于18岁以上成人全身性惊厥ED发作的患者。
Bottom Line:
要点:
As an alternative to phenytoin or fosphenytoin, valproate may be considered for refractory convulsive status epilepticus if benzodiazepines fail.
如果苯二氮卓类药物无效,作为苯妥英、磷苯妥英的替代物,对顽固性癫痫患者可考虑使用丙戊酸钠。

References 参考文献
American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Seizures:, Huff JS, Melnick ER, Tomaszewski CA, ThiessenME, Jagoda AS, Fesmire FM. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department WithSeizures[J]. Ann Emerg Med, 2014,63(4):437-447.
ACEP Clinical Policies Committee; Clinical Policies Subcommittee on Seizures. Clinical policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures[J]. Ann Emerg Med.2004 May;43(5):605-25.