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"刘永红" 10 results
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Release date：2020-03-20 08:06
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Release date：2021-06-24 01:24
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睡眠障碍是儿童神经科常见的问题，可单独发生或伴随其他神经疾病发生。睡眠障碍对儿童在认知、情绪、社会发展和行为表现等多方面造成损害。但是，一直以来，神经科医师对儿童睡眠障碍的认识相对较少，也缺乏睡眠评估和诊治的能力。失眠是儿科最常见的睡眠障碍，慢性睡眠障碍导致患儿白天出现精神行为异常及认知功能障碍，睡眠日记是诊断失眠的有力工具，行为咨询是儿童失眠管理的基础，认知行为治疗是治疗失眠的有效方法。异态睡眠和发作性睡病可能被误诊为癫痫发作等其他神经科疾病，导致不能得到及时有效的生活管理，出现不适当的药物暴露。文章着重介绍儿童失眠、异态睡眠和发作性睡病相应的临床表现、病理生理、诊断、治疗及研究现状，以期帮助神经科医生在诊治存在睡眠障碍的儿童过程中，准确诊断、提高对睡眠症状的评估及干预水平，优化疾病管理，改善患儿的睡眠状况，缓解家庭压力及照顾者的负担。
Release date：2017-11-27 02:36
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Release date：2018-09-18 10:17
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本文对最近发表于Epilepsia杂志的“Sleep physiology in patients with epilepsy: Influence of seizures on rapid eye movement （REM） latency and REM duration”一文进行解读，该研究以接受术前评估的成年药物难治性癫痫患者为研究对象，通过分析频谱图和视频脑电图发现，癫痫本身可以改变潜在的睡眠，对于癫痫发作和长期癫痫发作风险预警具有一定意义，并且首次提出了几个癫痫发作与睡眠的概念如primary sleep period、 perisleep等。通过文章解读，期望为相关专业人员提供癫痫研究新方向。
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ObjectiveTo summarize the method of quality management in long term video electroencephalogram (VEEG) monitoring process.MethodsTo summarize the VEEG monitoring process in 4 935 patients, the following methods were adopted: adequate preparation before examination, selection of suitable electrode wearing methods, regular inspection of the quality of the lead wire, inspection and observation of whether the electrodes have fallen off, process inspection, behavioral intervention guidance, timely manage the artifacts, pay more attention to the inducted experimental, timely identification of paroxysmal events, standardize the procedures for the management of seizures, standardize the processing of electrode cleaning and disinfection, continuously improve the quality.ResultsFour hundred and tworoy are paroxysmal events of various types occurred during the monitoring period. All of them were handled in time and the patients were all safe. Among these events, 4 children ended the examination in ahead of the normal procedure due to fever, crying or other reasons. two patients were transferred to intensive care unit due to changes in patients ’conditions such as hypopnea and decreased oxygen saturation of artery blood of finger. The remaining 4 829 patients completed VEEG detection for 8 ~ 24 h. and got good quality images.ConclusionsQuality management is a guarantee of qualified, high quality, low artifact EEG reports.
Release date：2019-03-21 11:04
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鉴于丙戊酸(Valproate, VPA)宫内暴露的致畸风险及其对胎儿生长发育的影响, 2014年10月隶属于欧洲药品管理局(European Medicines Agency, EMA)的相互认证和分布处理协调小组(Coordination Group for Mutual Recognition and Decentralised Procedures-Human, CMDh)建议加强对女性使用VPA的限制, 随后国际抗癫痫联盟欧洲事务委员会(Commission on European Affairs of the International League Against Epilepsy, CEA-ILAE)及欧洲神经病学学会(European Academy of Neurology, EAN)组成的工作小组在《Epilepsia》上撰文, 旨在对育龄期女性使用VPA做出指导。撰文时, 工作小组充分考虑了使用VPA与其它替代药物的致畸风险、控制癫痫发作的重要性、癫痫发作对患者及胎儿的危害、VPA及其它抗癫痫药物对癫痫控制效力等因素。最终的建议包括以下7点:①育龄期女性应尽量避免使用VPA; ②应在医生及患者(必要时患者代理人)共同商议后决定治疗方案, 依据癫痫类型及发作形式选择合理的治疗方案时, 应仔细进行风险-获益评估; ③对于最适合VPA治疗的发作类型及综合征, 应该充分向患者及家属解释VPA及其它替代药物的获益和潜在风险; ④VPA不应作为局灶性癫痫的一线治疗药物; ⑤VPA或许可以作为治疗某些癫痫综合征的一线用药, 如特发性(遗传性)全面性癫痫伴有强直阵挛发作; ⑥VPA或许可作为生育可能性极小的女性癫痫患者的一线用药, 如合并严重的智力或身体残疾; ⑦应持续随访服用VPA的育龄期女性患者, 以确定最佳治疗方案
