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[原创翻译]新生儿惊厥远期预后
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NEUROLOGY 2007;69:1816-1822 Long-term prognosis in children with neonatal seizures 目的：观察10岁以下伴新生儿惊厥的儿童远期预后并探索预后的标志物。 Methods: We prospectively diagnosed clinical neonatal seizures with high specificity for true epileptic seizures in a population-based setting of all live newborns in the province of Newfoundland, Canada, between 1990 and 1995. Children with neonatal seizures were followed by specialized provincial health services. Follow-up data were collected on epilepsy, physical and cognitive impairments, and other heath issues. 方法：选取加拿大纽芬兰省1990年至1995年出生的伴有新生儿惊厥的儿童，通过专门的省级卫生服务部门随访。随访数据包括癫痫、身体和认知损害以及其他健康项目。 Results: Data were available on 82 out of 90 subjects. We added information on six others whose outcome was clearly predictable from earlier information. Prognosis was better for term than for preterm infants (p = 0.003): term: 28 (45%) normal, 10 (16%) deaths, and 24 (39%) with impairments; preterm: 3 (12%) normal, 11 (42%) deaths, and 12 (46%) with impairments. Of survivors, 17 (27%) developed epilepsy, 16 (25%) had cerebral palsy, 13 (20%) had mental retardation, and 17 (27%) had learning disorders. Variables associated with poor prognosis were Sarnat stage III or equivalent severe encephalopathy, cerebral dysgenesis, complicated intraventricular hemorrhage, infections in the preterm infants, abnormal neonatal EEGs, and the need for multiple drugs to treat the neonatal seizures. Pure clonic seizures without facial involvement in term infants suggested favorable outcome, whereas generalized myoclonic seizures in preterm infants were associated with mortality. 结果：90例中有82例可获得资料，可通过早期资料明确推测结果的另外6例也一并加入。足月儿的预后好于早产儿(p = 0.003): 足月儿组28例(45%)正常，10例 (16%)死亡，24例(39%)存在损害；早产儿组3例 (12%)正常，11例(42%)死亡，12例(46%)损害。在存活者中，17例(27%)发展为癫痫，16 例(25%)为脑瘫， 13例(20%)有智力缺陷，17例(27%)有学习障碍。不良预后的影响因素是Sarnat stage III（不知道如何翻译？）或相当于严重的脑病、大脑发育不全、复杂的脑室出血、早产儿感染、脑电图异常以及需要药物治疗的新生儿惊厥。足月儿不累及面部的单纯阵挛预后较好，而早产儿肌阵挛与死亡率相关。 Conclusions: Poor prognosis for premature infants with seizures is reflected in high rates of subsequent long-term disability and mortality. The severity and timing of the pathologic process continue to be the major determinants for outcome. 结论：伴惊厥的早产儿预后不良表现在远期残疾率和死亡率。病理过程的严重性和时间性是预后的主要决定因素。 http://www.yuyucollege.cn/bbs/thread-50619-3-1.html |
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