德巴金注射液治疗惊厥性癫痫持续状态的临床研究

Clinical Study of Sodium Valproate in the Treatment of Convulsive Status Epilepticus

目的:研究德巴金注射液治疗惊厥性癫痫持续状态(CSE)的疗效和安全性。方法:选择2016年1月至2019年4月在江西省人民医院神经内科住院的120例惊厥性癫痫持续状态患者(年龄18~80岁),随机分为治疗组和对照组。治疗组予以德巴金注射液治疗,对照组应用地西泮、苯巴比妥交替治疗,观察两组的疗效和不良反应。结果:治疗组总有效率78.3%,对照组为75%,两组比较无统计学差异(P>0.05);67例老年患者(大于60周岁)中,治疗组有效率79.4%,对照组有效率75.8%,两组比较无统计学差异(P>0.05);老年患者中治疗组不良反应发生率2.9%,对照组不良反应发生率27.3%,两组比较有统计学差异(P<0.05);治疗组60例患者中发作持续时间≤6h的患者有效率95.7%,而发作持续时间>6h有效率72.7%,两组比较有统计学差异(P<0.05)。结论:德巴金注射液是一种快速起效、安全的广谱抗癫痫药,其与地西泮等传统的一线抗癫痫持续状态药物相比疗效相当,但其对于循环呼吸无抑制,可作为老年CSE患者,尤其是伴有肺部或心血管系统疾病患者的首选治疗用药,并且用药时间越早疗效越好。

Objective:To study the efficacy and safety of sodium valproate injection in the treatment of Convulsive epileptic status.Methods:120 patients of convulsive status epilepticus who admitted in our hospital from January 2016 to April 2019 were randomly divided into treatment group and control group.The treatment group was treated with sodium valproate injection,while the control group was treated with diazepam and phenobarbital alternately.Results:There were no significant difference of the total effective rate between the treatment group(78.3%)and the control group(75%)(P>0.05);and the effective rate of patients older than 60 years in the treatment group and the control group was 79.4%and 75.8%,respectively(P>0.05);The adverse reaction rate of patients older than 60 years was 2.9%in the treatment group and 27.3%in the control group(P<0.05).In the 60 patients in the treatment group,The effective rate with epileptic duration less than 6 hours was 95.7%and more than 6 hours was 72.7%,there was statistical difference between the two groups(P<0.05).Conclusion:Sodium valproate injection is a wide-spectrum antiepileptic drug which was safe,reliable,effective.Compared with diazepam or other traditional first-line antiepileptic drugs,it has the same effect.As there is no inhibition of circulatory respiration,it can be used as the first choice of treatment for elderly CSE patients,especially those with pulmonary or cardiovascular diseases.and the earlier the treatment time,the better the effect.