预防性强化抗癫痫治疗对院外心脏骤停患者预后的影响  

Effect of prophylactic antiepileptic treatment on the prognosis of out-of-hospital cardiac arrest patients

作　　者：孟玲[1] 刘莎莎[1] MENG Ling;LIU Shasha(Department of Emergency,Handan Central Hospital,Handan,Hebei,056001,China)

机构地区：[1]邯郸市中心医院急诊内2科,河北邯郸056001

出　　处：《临床急诊杂志》2024年第5期221-224,共4页Journal of Clinical Emergency

摘　　要：目的:探索预防性使用抗癫痫药物治疗节律性和周期性脑电图模式能否改善心脏骤停昏迷患者出院后3个月神经系统结局。方法:选取邯郸市中心医院急诊科EICU 2021年12月—2023年9月心脏骤停昏迷患者218例(GCS≤8分),1:1随机分配为标准治疗组和强化抗癫痫治疗组,在自主循环恢复24 h内开始连续脑电监测。标准治疗组给予规范化治疗,强化抗癫痫治疗组在此基础上,在脑电图出现节律性和周期性脑电图模式3 h内,采用升阶梯预防性抗癫痫策略至少48 h。观察幸存患者出院后3个月临床结局。结果:标准治疗组3个月神经系统预后不良(CPC≥3分)发生率为89.9%,强化抗癫痫治疗组为78.9%,差异有统计学意义(P=0.0251)。两组EICU住院时间和机械通气时间比较,强化抗癫痫治疗组略长于标准治疗组,差异无统计学意义(P>0.05)。结论:预防性使用抗癫痫药物治疗节律性和周期性脑电图模式能够改善心脏骤停昏迷幸存患者出院后3个月神经系统结局。Objective:To explore the preventive use of antiepileptic drugs to treat rhythmic and periodic electroencephalography(EEG) patterns to improve the ending of the nervous system for 3 months after out-of-hospital cardiac arrest(OHCA).Methods:Select 218 OHCA patients(GCS ≤8) from December 2021 to September 2023 in EICU of Handan Middle hospital.1∶1 randomly allocated as standard therapy group and antiepileptic therapy group.Within 24 h of return of spontaneous circulation,continuous EEG monitoring will be applied.The standard treatment group is given standardized treatment,while antiepileptic therapy group start elevation ladder prevention of anti-epilepsy within 3 h rhythmic and periodic EEG patterns appeared at least for 48 h.Observe the clinical ending of the survivors 3 months after discharge.Results:The incidence of poor prognosis(CPC≥3) in the standard treatment group was 89.9%,and the antiepileptic treatment group was 78.9%,the difference was statistically significant(P=0.0251).The EICU hospitalization and mechanical ventilation time of the anti-epilepsy treatment group were slightly longer than the standard treatment group,but the difference was not statistically significant(P>0.05).Conclusion:Preventive use of antiepileptic drugs to treat rhythmic and periodic EEG patterns can improve the end of the nervous system for 3 months after out-of-hospital cardiac arrest.

关 键 词：院外心脏骤停 缺氧缺血性脑损伤 脑电图 抗癫痫 

分 类 号：R472.2[医药卫生—急诊医学]