OUTCOME IN NEONATES WITH CONVULSIONS TREATED IN AN INTENSIVE-CARE UNIT
OUTCOME IN NEONATES WITH CONVULSIONS TREATED IN AN INTENSIVE-CARE UNIT
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DOI：
10.1002/ana.410140607
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发表时间：
1983-01-01
影响因子：
11.2
通讯作者：
DAVID, R
中科院分区：
文献类型：
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作者：
BERGMAN, I;PAINTER, MJ;DAVID, R
对1976-1979年间在单一重症监护病房接受治疗的131例1-5岁新生儿癫痫幸存者的神经学和发育结局进行了评估。一半的孩子出生时小于37周，28%的孩子出生时小于或等于31周。51例患儿检查正常，17例轻度异常，25例中度残疾，30例重度残疾，6例因深度神经功能缺损死亡，2例无法定位。26名儿童出现复发性非热性癫痫发作。大多数运动障碍或视力丧失的儿童智力迟钝，但15名双侧失明儿童中有10名智力正常。在77名癫痫发作由缺氧缺血性损伤引起的儿童中，41名发展为中度或重度残疾。通过多变量分析确定，该组新生儿预后不良的重要预测因素包括迟发性癫痫发作、强直性癫痫发作和持续多日的癫痫发作。虽然与癫痫发作相关的癫痫发作频率和新生儿死亡率在早产儿中最高，但存活下来的早产儿的结局与足月婴儿的结局没有显著差异。
Neurological and developmental outcome was assessed in 131 survivors of neonatal seizures aged 1-5 yr who were treated in a single intensive care unit from 1976-1979. Half the children were born at < 37 wk gestational age, and 28% at 31 wk or less. Children (51) were normal on examination, 17 had minor abnormalities, 25 had moderate disabilities, 30 had severe disabilities, 6 had died because of profound neurological deficits, and 2 could not be located. Recurrent nonfebrile seizures had developed in 26 children. Most children with motor handicaps or visual loss were intellectually retarded, but 10 of 15 children with bilateral haring loss were intellectually normal. Of 77 children whose seizures were caused by a hypoxic-ischemic insult, 41 developed moderate or severe disabilities. As determined by multivariate analysis, significant neonatal predictors of poor outcome in this group included seizures with late onset, tonic seizures and seizures lasting for many days. Although seizure frequency and neonatal mortality associated with seizures were greatest in very premature infants, the outcome in premature infants who survived was not significantly different from that of term infants.