Introducing the postoperative care team
Introducing the postoperative care team
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术后护理团队介绍
DOI：
10.1136/bmj.314.7078.389
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
D. R. Goldhill
中科院分区：
文献类型：
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作者：
D. R. Goldhill
令人惊讶的是，经过多年的科学研究和治疗进展，许多关于癫痫的简单而基本的问题仍然没有答案。由于抗癫痫药物的广泛使用，甚至癫痫的自然病程也不为人所知。高尔斯怀疑癫痫发作会引发随后的癫痫发作，换句话说，存在一种促进现象这个想法仍然存在，但尚未得到证实。我们也不知道抗癫痫药物是否会改变癫痫的自然病程并预防慢性和顽固性的发展。新诊断患者（尤其是儿童）进一步癫痫发作的风险是否值得与抗癫痫药物相关的副作用？开始治疗的最佳时间是什么时候？临床研究在这些问题上产生了分歧，有时甚至是相互矛盾的观点。
It is amazing how after years of scientific research and therapeutic progress many simple and basic questions about the epilepsies remain unanswered. Even the natural course of epilepsy is not well known because of the widespread use of antiepileptic drugs. Gowers suspected that seizures trigger subsequent seizures or, in other words, that there is a facilitation phenomenon.1 This idea still survives but has yet to be substantiated. We also do not know if antiepileptic drugs alter the natural course of epilepsy and prevent chronicity and intractability developing. Are the risks of further seizures in newly diagnosed patients (especially children) worth the side effects associated with antiepileptic drugs? What is the optimum time to begin treatment? Clinical studies have produced diverging and sometimes conflicting views on these problems.
In this week's BMJ , van Donselaar et al (p 401) followed 204 untreated children aged 1 month to 16 years who experienced one (123 patients) or more idiopathic or “remote symptomatic” tonic-clonic seizures (including seizures with partial onset).2 They analysed the time between seizures until the start of treatment, the fourth untreated seizure, or the end …