颅脑损伤患者术后癫痫发作情况及丙戊酸钠预防性抗癫痫效果分析

Analysis of the situation of craniocerebral trauma operation patients with epilepsy seizures and the effect of sodium valproate prophylactic antiepileptic

目的探讨颅脑损伤患者术后癫痫的发作情况以及丙戊酸钠预防性抗癫痫发作的临床效果。方法选取2014年9月至2016年9月我院收治的颅脑损伤患者164例,按照随机数字表法分为观察组与对照组,每组82例。观察组患者术前、术中、术后给予丙戊酸钠预防性抗癫痫治疗,对照组患者不给予预防性抗癫痫治疗。观察计算患者术后1个月内癫痫发生率、不同损伤类型患者癫痫发生率、不同损伤严重程度患者癫痫发生率;比较观察组和对照组患者术后1个月内的癫痫发生率。结果颅脑损伤患者164例中,术后1个月内癫痫发作32例,发生率为19.51%。闭合性脑损伤患者术后癫痫发生率(5.0%)低于开放性脑损伤(42.2%),差异有统计学意义(P<0.01);重度颅脑损伤患者术后癫痫发生率(39.3%)显著高于轻中度颅脑损伤患者(7.8%),差异有统计学意义(P<0.01)。观察组患者术后1个月癫痫发生率(1.2%)显著低于对照组(37.8%),差异有统计学意义(P<0.01)。结论颅脑损伤患者术后癫痫的发生率较高,术前、术中、术后给予丙戊酸钠预防性抗癫痫治疗可显著降低患者术后癫痫发生率,促进患者康复。

Objective To evaluate the situation of craniocerebral trauma operation patients with epilepsy seizures and the effect of sodium valproate prophylactic antiepileptic. Methods 164 cases of Craniocerebral trauma treated in our hospital from September 2014 to September 2016 were selected. Which were divided into the observation group and the control group, 82 cases in each group according to the random number table method. The observation group were treated with sodium valproate of preventive antiepileptic perioperative treatment, and the control group did not give preventive antiepiteptic treatment. The incidence of epilepsy within 1 months after operation, the incidence of epilepsy in different types of patients, and the incidence of epilepsy in patients with different severity of trauma were observed. The incidence of epilepsy was compared between two groups within 1 months after the operation. Results There were 32 cases of epileptic seizures found within 1 months after operation, and the incidence was 19.51%. The incidence of postoperative epilepsy in patients with closed brain trauma （5%） was lower than that of open brain trauma（42.2% ）, and the difference was statistically significant （ P 〈 O. 01 ）. The incidence of postoperative epilepsy in patients with severe craniocerebral trauma （39.3%） was higher than that of patients with mild and moderate craniocerebral trauma （7.8%）. The difference was statistically significant （P 〈 0.01 ）. The incidence of epilepsy （ 1.2% ） in the observation group was lower than that of the control group （ 37. 8% ） 1 months after operation, and the difference was statistically significant （ P 〈 0. 01 ）. Conclusion The incidence of epilepsy after craniocerebral trauma is high. Prophylactic antiepileptic perioperative treatment with valproate can significantly reduce the incidence of epilepsy and promote recovery of patients.