非酮症性糖尿病性癫痫的循证治疗

    Evidence-Based Treatment of A Nonketotic Diabetic Patient with Epilepsy

    • 摘要: 目的 针对收治的 1 例少见的非酮症性糖尿病性癫痫患者,检索当前最佳证据,为临床合理治疗提供依据。 方法 计算机检索 Cochrane 图书馆(2011 年第 4 期)、PubMed (1966年至2012年4月)、EMBASE (1974年至2012年4月)、CBM (1978年至2012年4月)、CNKI (1979年至2012年4月),按证据级别高低查找相关证据,并对所获证据进行评价。 结果 共检索到 316 篇文献,无临床指南和系统评价,也无临床对照研究。有关临床治疗的文献共有 65篇,包括3种治疗方案,结合患者意愿,给予小剂量胰岛素控制血糖、补液、改善微循环、预防脑水肿,血糖水平趋于平稳,未见癫痫样抽搐发生。随访8个月,血糖控制好,未见癫痫样抽搐发作。 结论 早期诊断非酮症性糖尿病性癫痫可避免漏诊、误诊,改善预后。

       

      Abstract: Objective To identify the best therapeutic regimen for a rare nonketotic diabetic patient with epilepsy. Methods We searched the Cochrane Library (Issue 4, 2011), PubMed (1966 to April 2012), EMBASE(1974 to April 2012), CBM (1978 to April 2012) and CNKI (1979 to April 2012) to identify relevant evidences. The quality of the retrieved studies was critically assessed. Results A total of 316 records were retrieved. No clinical guidelines, systematic reviews or clinical randomized studies were identified. According to sixty-five treatment-related literatures involved 3 interventions, combined with the patient preference, small doses insulin was given to control blood sugar and fluid infusion, with improved microcirculation and prevention of cerebral edema, blood sugar levels gradually stabilized, and there was no occurrence of epileptic seizures anymore. Follow-up of 8 months, blood glucose was under control and no more epileptic seizures relapse. Conclusion Early diagnosis of nonketotic diabetes epilepsy could prevent the misdiagnosis and improve clinical outcome.

       

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