血液透析过程中癫痫发作的临床特征及治疗

Clinical Features and Treatment of Epileptic Seizure During Hemodialysis

目的探讨尿毒症患者在血液透析中癫痫发作的原因及临床特征。方法对2006年8月—2011年12月我院收治的45例血液透析过程中癫痫发作的患者的临床资料进行回顾性分析,总结癫痫发作的原因及其临床特点。结果抗生素脑病(15例)、透析失衡(13例)、尿毒症脑病(7例)是诱发癫痫的主要原因;主要表现为强直-阵挛性发作;经静脉注射地西泮注射液5～10 mg及其他治疗,除2例脑出血、1例脑肿瘤患者救治无效死亡外,其余患者的癫痫症状均得到控制。结论尿毒症患者在血液透析过程中癫痫发作的诱因及临床表现较多,应根据实验室及辅助检查预防或及时救治癫痫的发作。

Objective To investigate the cause of epileptic seizure during hemodialysis and summarize clinical fea- ture. Methods Clinical data of 45 patients having epileptic seizure during hemodialysis from August 2006 to December 2011 in our hospital were analyzed retrospectively. The cause of epileptic seizure and clinical features were summarized. Results Antibiotics eneephalopathy （15 cases ）, dialysis disequilibrium syndrome （13 cases） and uremic encephalopathy （7 cases） were the main causes for epileptic seizure. The main clinical manifestation was tonic clonic - seizure. After giving 5 ~ 10 mg Diazepam injec- tion intravenously and other therapies, two cases had cerebral hemorrhage and one case died of brain tumor, but the epilepsy symptoms of other cases were controlled. Conclusion The cause and clinical manifestations for uremic patients having epileptic seizure during hemodialysis are various. Prevention and treatment of epileptic seizure should be based on laboratory and auxiliary examinations.