从儿童到成人的医疗保健系统的转变对许多患有癫痫的年轻人及其家庭来说是一个挑战。最近,加拿大安大略省卫生部和长期医疗部门成立了一个过渡工作组(Transition working group,TWG),为安大略省癫痫患者的过渡提出建议。在此对这项工作做出总结。TWG 包括儿科和成人癫痫病专家、精神科医生和来自学术界和社区的家庭医生,从事儿童和成人癫痫项目的社区医师、护士和社会工作者,以及青少年内科医师、律师、职业治疗师、社区癫痫机构的代表、癫痫患者和患者父母。该小组主要解决 3 个领域的问题:① 癫痫的诊断和管理;② 癫痫患者心理健康和社会心理需求;③ 癫痫患者经济、社会和法律支持。目前虽然还没有对过渡方案的结果进行系统研究,但 TWG 能早期识别处于过渡失败风险的青少年,在实际过渡之前即应协调儿童和成人神经科医师以及其他专家。过渡期是重新思考诊断和重复诊断检测(特别是基因检测,现有技术较多年前可发现更多病因)的理想时期。在转至成人医疗系统后部分筛查应重复。文章提出的 7 个步骤可以促进过渡,从而有助于为青少年癫痫患者转出儿童保健系统提供持续且合理的医疗服务。
Citation: Danielle M.Andrade, Anne S.Bassett, EduardBercovici, 刘旭 译, 熊维希 慕洁 审. 癫痫:从儿童至成年的医疗过渡—来自安大略省癫痫执行工作组的建议. Journal of Epilepsy, 2018, 4(4): 362-373. doi: 10.7507/2096-0247.20180060 Copy
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- 13. Kokkonen J, Kokkonen ER, Saukkonen AL, et al. Psychosocial outcome of young adults with epilepsy in childhood. J Neurol Neurosurg Psychiatry, 1997, 62(3): 265-268.
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- 15. Jalava M, Sillanpää M. Physical activity, health-related fitness, and health experience in adults with childhood-onset epilepsy: a controlled study. Epilepsia, 1997, 38(4): 424-429.
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