麻醉剂在难治性癫痫持续状态的应用  

Application of anesthetic drugs in the therapy of refractory status epilepticus

作　　者：贾鑫磊[1] 钱素云[1] 

机构地区：[1]首都医科大学附属北京儿童医院重症医学科,100045

出　　处：《中国小儿急救医学》2016年第11期727-730,735,共5页Chinese Pediatric Emergency Medicine

摘　　要：难治性癫痫持续状态是指尽管用了足量的一线及二线抗癫痫药物仍然不能控制发作的情况，是儿童神经系统急重症，有较高的病死率。多数意见推荐静脉注射麻醉药物治疗难治性癫痫持续状态，以达到全面控制发作，治疗性昏迷及脑电爆发抑制。然而，对于最佳麻醉药物及麻醉深度并无一致意见，持续静脉麻醉诱导昏迷所带来的风险收益比也不十分清楚，麻醉剂治疗难治性癫痫持续状态仍需谨慎。本文介绍了治疗儿童难治性癫痫持续状态常用的静脉麻醉药物，也探讨了临床应用麻醉剂的合理性及争议。Refractory status epilepticus is a pediatric neurological emergency and associated with high morbidity and mortality. Refractory status epilepticus is commonly defined as status epilepticus resistant to adequate first-and second-line antiepileptic drugs. Most opinions recommend intravenous anesthetic drugs for treatment-refractory status epilepticus to induce total seizure suppression,or therapeutic coma with an elec-troencephalography burst-suppression pattern. However,there is no consensus regarding the best agent or level of sedation by which to accomplish seizure control, and risk-benefit ration of therapeutic coma induced by continuously administering intravenous anesthetic drugs in this setting is unclear. This calls for caution in the straightforward use of anesthetics in treating status epilepticus. In this overview,we introduced the use of gen-eral anesthesia drugs for intravenous infusion in pediatrics,the rational and the conflicting clinical implications of anesthetic drugs in patients with treatment-refractory status epilepticus are discussed.

关 键 词：麻醉剂 难治性癫痫持续状态 治疗 

分 类 号：R726.1[医药卫生—儿科] R742.1[医药卫生—临床医学]