摘要
目的探讨丙戊酸钠注射液治疗地西泮不能控制的难治性癫痫持续状态(RSE)的疗效和安全性。方法1999年9月-2007年5月连续登记的25例经地西泮静滴、苯巴比妥肌注治疗未能控制的RSE患者,评估其使用丙戊酸钠注射液控制RSE的疗效及不良反应。患者中男性10例,女性15例,平均年龄为55岁。发作类型包括全面强直阵挛发作持续状态(GTCS)14例,复杂部分发作持续状态(CPS)7例,单纯部分发作持续状态(SPS)2例,肌阵挛持续状态(MS)2例。25例患者中病毒性脑炎13例,停药或不正规服用抗癫痫药物(AEDs)的癫痫患者5例,颅脑手术后3例,脑梗死后2例,中毒后1例,脑瘫1例,其中既往有癫痫病史者9例。结果丙戊酸钠治疗后,22例患者1h内癫痫持续状态(SE)得到控制,1h后意识基本恢复。治疗前后的血、尿常规,肝、肾功能,心电图及血压、心率、呼吸无明显变化,无脑病发生。3例未控制患者痫性发作频率降低,每次发作持续时间缩短。结论丙戊酸钠注射液作为非镇静性抗惊厥药物对地西泮未能控制的多种类型的RSE是安全有效的,患者意识恢复较快,没有明显的不良反应。
Objective To explore the efficiency and safety of sodium valproate intravenous therapy on refractory status epilepsy （RSE） by diazepam in Chinese adult. Methods Twenty-five patients of RSE, consecutively admitted to West China Hospital of Sichuan University from September 1999 to May 2007, received intravenous administration of sodium valproate after being refractory to intravenous diazepam and intramuscular phenobarbitone. The efficiency and side effect of sodium valproate were then evaluated. There were ten males and fifteen females with mean age of fifty-five years. The symptoms of status epilepticus （SE） included generalized tonic-clonic status epilepticus （GTCS） （14 cases）, complex partial status epilepticus （CPS） （7 cases）, simple partial status epilepticus （SPS） （2 cases） and myoclonic status epielepticus （MS） （2 cases）. The primary diseases prior to SE were viral encephalitis （13 cases）, withdrawal of antiepilepsy drug （AEDs） （5 cases）, cerebral trauma and brain surgery （3 cases）, cerebral infarction （2 cases）, intoxication （1 case） and cerebral palsy （1 case）. Among them nine patients had a history of epilepsy. Results Of all the 25 cases of RSE, twenty-two were controlled with sodium valproate within one hour, and consciousness recovered within next one hour. No significant changes were found in blood pressure, heart rate, respiratory rate and cardiac rhythm, and no encephalopathy occurred. On the other hand, the other three cases who failed to be controlled, frequency and duration of seizure were redured. Collusions Although intravenous sodium valproate has not been approwd to be the drug of first choice for SE therapy, but it is non-sedative anti-convulsion drug that can be safely used to stop different kinds of diazepam resistant SE efficiently without obvious side effect. In addition, a quick recovery of patients＇ consciousness may be expected within an hour afte RSE being controlled.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2008年第2期200-201,共2页
Medical Journal of Chinese People's Liberation Army
