海洛因依赖并发癫痫大发作情况分析

ANALYSIS OF GRAND MAL IN HEROIN DEPENDENT PATIENTS

目的:探讨海洛因依赖伴癫痫大发作的情况及临床治疗对策。方法:对我院2002-2005年收治的5328例海洛因依赖自愿戒毒者中伴癫痫大发作的资料进行回顾性分析。结果:在5328例中,伴癫痫大发作30例,占0.56%;其中滥用时间在5a以上者23例(76.7%);静脉注射者的比例(86.7%)高于烫吸者(13.3%),P<0.05;27例(90.0%)伴有BZD类多药滥用;13例(43.3%)有MDMA等苯丙胺类滥用史。对BZD类药物依赖者,给予了同类药物的替代递减治疗。结论:在海洛因依赖者中存在癫痫大发作现象。这可能与滥用的药物、滥用方式、滥用时间等因素有关。多药滥用者突然停用BZD类药物、减量过快可能诱发癫痫大发作。给予同类药物替代递减治疗,可减少癫痫大发作的发生。

Objective：To understand the situation of grand mal in heroin dependent patients and undertake clinical countermeasures against it. Methods： A retrospective analysis was performed in 5328 heroin dependent patients admitted by Zhuhai Ruihua Rehabilitation Centre from 2002 -2005. Results： Among 5328 heroin dependent patients, 30 cases had grand mal, accounting for 0. 56%. Of the 30 cases, 23 （76.7%） had a history of drug abuse for more than 5 years; 86.7% of them were intravenous drug users（IDUs） which was much higher than that of chasing dragon（ 13.3% ）, P 〈0. 05; polydrug abuse was popular, including 27 （90. 0% ） cases using benzodiazepines （ BZD ）, 13 （43.3 % ） cases taking amphetamines. For those with benzodiazepines use, substitution treatment was provided. Conclusion ： Incidence of grand mal exists in heroin dependent patients, which might be related with drugs abused, drug administration routes and duration of drug abuse. Sudden withdrawal or decreasing the dose of BZD quickly can induce grand mal, which can be prevented by substitution treatment.