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目的:系统评价脑卒中后癫痫发病的主要危险因素,为临床对该病的防治提供一定的依据和借鉴。方法:由两名检索人员通过计算机检索Pub Med、EMbase、中国知网CNKI、CBM、万方数据库、维普数据库VIP,检索时间均为建库时间至2016年4月25日。全面搜集脑卒中后癫痫发病危险因素的病例-对照研究。两名评价者依据本荟萃分析的纳入及排除标准独立对文献筛选、资料提取及质量评价后,采用Rev Man5.3软件进行Meta分析。结果:共有8篇文献纳入到本研究,共纳入3423例研究对象,其中脑卒中发生癫痫439例,脑卒中后未发生癫痫2984例。Meta分析结果显示:颅内压增高、多脑叶病灶、脑出血、脑梗死、电解质紊乱、病灶累及皮质与脑卒中癫痫的发病相关,其OR值(95%CI)分别为0.3(0.15,0.61)、6.36(4.75,8.51)、1.54(1.24,1.93)、0.61(0.49,0.76)、0.23(0.14,0.37)、5.04(4.02,6.32)。结论:脑卒中后癫痫的发病与颅内压增高、多脑叶病灶、脑出血、脑梗死、电解质紊乱、病灶累及皮质有关,可为临床脑卒中后癫痫的预防提供依据。
Objective: To systematically evaluate the main risk factors of epilepsy after stroke and provide some evidences for clinical prevention and treatment of this disease. Methods: Two search personnel searched Pub Med, EMbase, CNKI, CBM, Wanfang Database and VIP database VIP by computer. The search time was from April 25 to April 25, 2016. A Case-Control Study of Comprehensively Collecting Risk Factors for Epilepsy after Stroke. Two reviewers independently reviewed, screened, and assessed the quality of the literature based on the inclusion and exclusion criteria of this meta-analysis. Meta-analysis was performed using RevMan5.3 software. Results: A total of 8 articles were included in this study. A total of 3423 subjects were enrolled, including 439 cases of stroke and 2984 cases of epilepsy after stroke. The results of Meta analysis showed that the OR value (95% CI) of intracranial pressure, multilobular foci, cerebral hemorrhage, cerebral infarction, electrolyte imbalance, focal cortical involvement and stroke and epilepsy were 0.3 (0.15,0.61 ), 6.36 (4.75, 8.51), 1.54 (1.24, 1.93), 0.61 (0.49, 0.76), 0.23 (0.14, 0.37), 5.04 (4.02, 6.32). Conclusion: The incidence of epilepsy after stroke is related to increased intracranial pressure, multilobular foci, cerebral hemorrhage, cerebral infarction, electrolyte imbalance and cortical involvement in the lesions, which may provide evidence for the prevention of post-stroke epilepsy.