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目的:对癫痫患者单药正规治疗3年且无临床发作停药后复发的相关因素进行分析。方法:选择自2010年1月-2014年1月本院神经内科收治癫痫患者100例,入选患者行单药正规治疗3年且无临床发作。停药前24 h VEEG痫性放电≤5次/24 h。随访符合要求患者1年,若发生复发则随访停止。比较分析患者年龄、性别、停药前24h VEEG、影像检查中颅内病灶的有无,癫痫发作类型、频率以及形式,以及治疗方案,治疗时间等因素。结果:最终70例患者进行最后统计分析,24例患者在1年随访期内有复发(31.2%),性别、年龄、停药处理前脑电图形式、癫痫发作类型、用药方案、是否存在癫痫持续状态这几项内容的比较差异无统计学意义(P>0.05),停药前发作形式(P=0.014)、影像检查颅内病灶的有无(P=0.021)、开始治疗前癫痫发作频率的大小(P=0.035)、以及开始治疗前病程长短(P=0.006)四项内容具有统计学差异。41.7%患者无明显诱因即癫痫复发,而长时间玩电脑、休息不足以及饮酒等不良生活方式在复发诱因中占比37.5%,感染的发生占癫痫复发诱因的16.7%。结论:对单药正规治疗3年且无临床发作的癫痫患者停药处理后,仍存在高危因素导致其癫痫复发,对这些高危因素的明确在对癫痫患者的停药处理中具有指导作用,对其停药后癫痫复发的减少有显著帮助。
OBJECTIVE: To analyze the related factors of recurrence of patients with epilepsy after formal treatment of monotherapy for 3 years and without clinical seizures. Methods: From January 2010 to January 2014, 100 patients with epilepsy were enrolled in our department of neurology. The selected patients were treated with formalin for 3 years without clinical attack. VEEG epileptic discharge 24 h before stopping ≤ 5 times / 24 h. Follow-up patients meet the requirements for 1 year, if the recurrence of follow-up to stop. Comparative analysis of patients age, gender, 24h VEEG before discontinuation, intracranial lesions in the imaging examination, the type and frequency of seizures, as well as the form and treatment options, treatment time and other factors. RESULTS: The final 70 patients were analyzed by final statistical analysis. Twenty-four patients had recurrence (31.2%) at 1-year follow-up, sex, age, EEG electrocardiogram before withdrawal, type of seizure, medication regimen, presence of epilepsy (P = 0.014), the presence or absence of intracranial lesions (P = 0.021), the frequency of seizure onset before treatment, the difference between the two groups was not statistically significant (P> 0.05) (P = 0.035), and the duration of the course of disease before starting treatment (P = 0.006). 41.7% of patients had no obvious incentive to recurrent epilepsy. However, playing prolonged computer games, lack of rest and drinking and other unhealthy lifestyles accounted for 37.5% of the recurrent inducement, and infection accounted for 16.7% of the recurrent inducement of epilepsy. Conclusion: There is still risk factors for the recurrence of epilepsy in patients with epilepsy after 3 years of regular monotherapy and without clinical seizure. The clear definition of these high risk factors can guide the withdrawal of epilepsy patients. The withdrawal of epilepsy after the withdrawal of a significant help.