亚低温治疗对儿童癫痫持续状态的安全性及脑保护作用的临床研究

Brain Protection Effect and Safety of Hypothermia in Children with Status Epilepticus

目的分析亚低温治疗对儿童癫痫持续状态的安全性及脑保护作用。方法选择2010年7月～2014年7月间接受住院治疗的癫痫持续状态患儿82例为研究对象，采用随机数字表法分为观察组和对照组各41例，对照组患儿采用癫痫持续状态常规治疗，观察组患儿在常规治疗基础上加入亚低温治疗。比较两组格拉斯转归量表评分（GOS）、氧化应激水平、并发症、治疗效果。结果治疗效果：观察组有效率95．12％明显高于对照组80．49％（x2=6．500，P〈0．05）；GOS评分：观察组GOS评分（4．68±0．24）明显高于对照组（4．32±0．15）（t=8．145，P〈0．05）；氧化应激反应：观察组超氧化物歧化酶（SOD）明显高于对照组，丙二醛（MDA）、晚期氧化蛋白产物（AOPP）、一氧化氮（NO）明显低于对照组（t=4．402～21．508，P〈0．05）；不良反应：两组肺部感染、心律失常、凝血功能障碍等并发症比较，差异无统计学意义（x2=0．346～1．051，P〉0．05）。结论亚低温治疗有助于保护癫痫持续状态儿童脑功能，缓解全身氧化应激状态，提高治疗效果。

Objective To analyze brain protection effect and safety of hypothermia in children with status epilepticus. Methods 82 cases of children with status epilepticus between July 2010 to July 2014 in our hospital were randomly divided into observation group （ n = 41） and control group（n =41 ）. Pationtsin control group were given routine therapy, and those in observation group were given routine therapy combined with hypothermia therapy on the basis of conventional treatment. GOS, oxidative stress level, complications, therapy effect were compared between two groups. Results Therapy effect： observation group efficient 95.12% was significantly higher than that of control group （80.49%）（X2 = 6. 500, P 〈 0.05 ）. GOS score： observation group GOS score （4.68 ±0.24） was significantly higher than the control group （4.32 ±0.15） （ t = 8. 145, P 〈 0.05 ）. Oxidative stress response ： observation group SOD was significantly higher than that of control group, and MDA, AOPP, NO were significantly lower than the control group（ t = 4. 402 - 21. 508, P 〈 0.05 ）. Ad- verse reactions： there was no statistically difference in lung infection, arrhythmia, blood coagulation dysfunction between two groups （X2 = 0. 213- 1. 051, P 〉 0.05）. Conclusion Hypothermia treatment helps to protect status epilepticus children＇s brain function, relieve oxidative stress, and improve treatment effect.