癫痫持续状态诊断与治疗研究现状

doi:10.12092/j.issn.1009-2501.2026.02.005

摘要/Abstract

摘要：

癫痫持续状态（SE）是一种严重的急危重症，对患者危害极大。过去10余年来，SE研究方面取得一系列重要进展，本文全面参考近年来国内外权威指南、专家共识以及最新前沿研究成果，叙述了SE的最新进展、诊断与治疗研究现状等。并进一步探究SE在当下临床实践中所面临的关键挑战，对未来发展趋势进行预测，旨在为临床实践提供助力。

关键词: 癫痫, 惊厥性癫痫持续状态, 非惊厥性癫痫持续状态

Abstract:

Status epilepticus (SE) is a severe critical condition that poses a great threat to patients. Over the past decade or so, a series of important progress has been made in the research of SE. This article comprehensively refers to the recent domestic and foreign authoritative guidelines, expert consensus, and the latest cutting-edge research results, and describes the latest progress of SE, as well as the current research status of its diagnosis and treatment. It further explores the key challenges faced by SE in current clinical practice and predicts the future development trends, aiming to provide assistance for clinical practice.

Key words: epilepsy, convulsive status epilepticus, non-convulsive status epilepticus

中图分类号:

曲悠扬, 朱雨岚. 癫痫持续状态诊断与治疗研究现状[J]. 中国临床药理学与治疗学, 2026, 31(2): 175-184.

Youyang QU, Yulan ZHU. The current research status of the diagnosis and treatment of status epilepticus[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(2): 175-184.

图/表 3

参考文献 63

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分类标准	类型		定义
分类标准	类型		T1 （可能导致持续发作时间）	T2 （可能导致长期后果时间）
根据癫痫发作持续时间及发作长期后果分类	强直阵挛性癫痫发作		5 min	30 min
	伴意识障碍的局灶性癫痫发作		10 min	>60 min
	失神状态癫痫持续状态		10～15 min	未知
根据癫痫发作持续时间和治疗反应分类	早期或可能的癫痫持续状态		持续或间歇性癫痫发作，持续时间超过5 min，发作间期无意识恢复
	确诊癫痫持续状态		对一线苯二氮?类药物治疗无反应的癫痫发作
	难治性癫痫持续状态		使用两种足够剂量抗癫痫药物（如一线苯二氮?类药物+ 二线非苯二氮?类）后仍持续发作
	超难治性癫痫持续状态		使用麻醉剂治疗，难治性癫痫持续状态仍持续超过24 h或在撤机麻醉后复发的难治性癫痫持续状态
	特定综合征	NORSE	无癫痫病史或明确病因的患者突发难治性癫痫持续状态
	特定综合征	FIRES	儿童在发热性感染后急性发作难治性癫痫持续状态，伴认知功能损害

分类标准	类型		定义
分类标准	类型		T1 （可能导致持续发作时间）	T2 （可能导致长期后果时间）
根据癫痫发作持续时间及发作长期后果分类	强直阵挛性癫痫发作		5 min	30 min
	伴意识障碍的局灶性癫痫发作		10 min	>60 min
	失神状态癫痫持续状态		10～15 min	未知
根据癫痫发作持续时间和治疗反应分类	早期或可能的癫痫持续状态		持续或间歇性癫痫发作，持续时间超过5 min，发作间期无意识恢复
	确诊癫痫持续状态		对一线苯二氮?类药物治疗无反应的癫痫发作
	难治性癫痫持续状态		使用两种足够剂量抗癫痫药物（如一线苯二氮?类药物+ 二线非苯二氮?类）后仍持续发作
	超难治性癫痫持续状态		使用麻醉剂治疗，难治性癫痫持续状态仍持续超过24 h或在撤机麻醉后复发的难治性癫痫持续状态
	特定综合征	NORSE	无癫痫病史或明确病因的患者突发难治性癫痫持续状态
	特定综合征	FIRES	儿童在发热性感染后急性发作难治性癫痫持续状态，伴认知功能损害

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