老年人脑血管病并发癫痫的临床特点  

Clinical characteristics of cerebrovascular disease complicated with secondary epilepsy in the elderly

作　　者：谢清 谷晓莉 万久香 张丽娜 彭月黎 Xie Qing;Gu Xiaoli;Wan Jiuxriang;Zhang Lina;Peng Yueli(Department of Neurology,Three Gorges Hospital Affiliated to Chongqing University,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院神经内科,重庆404000

出　　处：《中华老年医学杂志》2020年第9期1025-1028,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年脑血管病后继发癫痫患者的临床特点,并提出针对性照护措施。方法选取2018年3月至2019年12月重庆大学附属三峡医院收治的老年脑血管病后继发癫痫患者106例作为癫痫组,另选取同期重庆大学附属三峡医院收治的单纯脑血管病患者106例作为对照组,对两组患者的临床特征和癫痫发作情况进行观察,并制定针对性照护措施。结果癫痫组患者脑出血比例、多脑叶梗死比例、皮质受累比例及异常脑电波比例分别为71(66.99%,71/106)、73(68.87%,73/106)、88(83.02%,88/106)、75(70.75%,75/106),均明显高于对照组46(43.40%,46/106)、49(46.23%,49/106)、65(61.32%,65/106)、57(53.77%,57/106)(χ2=11.921、11.121、12.424、6.505,均P<0.05)。癫痫组和对照组患者治疗前NFD评分分别为(22.7±4.8)分、(23.4±5.1)分,两组治疗前NFD评分比较差异无统计学意义(t=1.029,P=0.152);癫痫组患者治疗3个月后NFD评分为(14.3±2.9)分,明显高于对照组NFD评分(10.1±2.5)分(t=11.294,P=0.000)。结论癫痫是一种常见的脑血管病并发症,其中以脑出血患者最为常见,多脑叶病变、皮质受累可造成脑血管病患者癫痫发生风险增加,对患者实施必要的治疗和照护以减轻癫痫发作对脑血管病患者病情变化以及预后的影响十分重要。Objective To investigate clinical characteristics of cerebrovascular disease complicated with secondary epilepsy in the elderly,and to provide the targeted health care measures.Methods The 106 elderly patients with epilepsy secondary to cerebrovascular diseases treated in Three Gorges Hospital Affiliated to Chongqing University were enrolled as the epilepsy group,and another 106 patients with single cerebrovascular disease without secondary epilepsy during same period were included as the control group.Clinical features and epileptic seizure activity were observed and analyzed,and the targeted health care measures were developed.Results The proportions of patients with cerebral hemorrhage,cerebral lobe infarction,cortical dysfunction and abnormal brain waves were higher in the epilepsy group[66.99%(71 cases).68.87%(73 cases).83.02%(88 cases).70.75%(75 cases),respectively]than in the control group(43.40%or 46 cases.46.23%or 49 cases,61.32%or 65 cases,53.77%or 57 cases)(X2=11.921.11.121.12.424.6.505,all P<0.05).NFD scores before treatment had no significant difference between the epilepsy group and the control group(22.7±4.8 us.23.4±5.1.1=1.029.P=0.152).NFD score after 3 months of treatment was higher in the epilepsy group than in the control group(14.3±2.9 us.10.1±2.5.1=11.294.P=0.00).Conelusions Epilepsy is a common complication of various cerebrovascular diseases among which the cerebral hemorrhage is the most common.Polyloencephalopathy and cortical involvement can increase the risk of epilepsy in patients with cerebrovascular diseases.Therefore,it is very important to provide the necessary treatment and health care.so as to reduce the impact of epileptic seizure on the disease condition and improve prognosis in patients with cerebrovascular disease.

关 键 词：脑血管障碍 癫痫 

分 类 号：R743[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]