丙泊酚在癫痫持续状态患者治疗中的应用

Application of propofol in the treatment of status epilepticus patients

目的探讨丙泊酚（得普利麻）在治疗癫痫持续状态患者中的应用价值。方法回顾性分析2005-01～2008-11收治的36例癫痫持续状态患者的治疗经过，将患者分为两组。A组在每次癫痫发作时给予丙泊酚静脉注射，B组持续静脉泵入丙泊酚，同时在每次癫痫发作时给予丙泊酚静脉注射。监测患者血甘油三酯浓度和肝脏功能。结果两组患者在每次静脉注射丙泊酚后1～2min内抽搐全部控制；丙泊酚平均用量A组为（1．81±0．09）mg·kg^-1·h^-1，B组为（1．76±0．07）mg·kg^-1·h^-1，差异无统计学意义（P〉0．05）。A组患者每天的平均发作频率明显比B组高，差异有统计学意义（P〈0．05）。35例患者监测血甘油三酯未见升高，1例在治疗21d后测定血甘油三酯升高，停用丙泊酚，加用改善血脂代谢药物，8d后实验室测血甘油三酯正常。监测肝脏功能均未见异常。结论持续静脉泵入丙泊酚可以减少癫痫持续状态患者的发作频率，严密监测患者，可防止可能出现的并发症。

Objective To discuss the application of propofol （ Diprivan ） to the treatment of status epilepticus patients. Methods The 36 cases with status epilepticus were retrospectively analyzed from January 2005 to November 2008 and were divided into 2 groups, Group A ：when epileptic seizures occurred, propofol was given by vein injection; Group B： the propofol was continued to pump into the vein, at the same time propofol was also given by intravenous injection each seizure. The blood triglyceride levels and liver function of the patients were monitored. Results The seizures of two groups were all controlled within 1 ～2 min after the intravenous propofol. The average amount of propofol in group A was （1.81 ±0. 09 ） mg·kg^-1·h^-1 and group B was （ 1.76±0. 07 ） mg·kg^-1·h^-1（ p 〉0. 05 ）. The average frequency of epileptic seizures in A group were significantly higher than those of group B （ P 〈 0.05 ）. The blood triglycerides did not increase in 35 cases, except 1 case after 21 - day treatment. After stopping the propofol, and the drug was used to improve blood lipid metabolism, the blood triglyceride was back to normal at 8th day. The liver function was normal. Conclusion Application of continuous intravenous infusion of propofol can reduce the seizure frequency of the status epilepticus patients, and the patients should be monitored closely so as to prevent the complications.