苯巴比妥长期用于部分性癫痫发作患儿治疗的安全性研究

Study on the Safety of Long-term Use of Phenobarbital in the Treatment of Children with Partial Epilepsy in Pediatrics

目的:探究苯巴比妥长期用于癫痫部分性发作患儿的安全性。方法:本次研究连续选入2019年8月-2020年8月该院儿科门诊收治的96例癫痫部分性发作患儿为研究对象,依照随机数字表法分为研究组和对照组,各48例。两组患儿均进行基础治疗干预,在此基础上,研究组采用苯巴比妥治疗,对照组采用卡马西平治疗,疗程均为6个月。在治疗第1个月结束时,比较两组患儿的早期后遗效应;在治疗第6个月结束时,比较两组患儿的治疗效果、远期后遗效应、药物耐受和药物依赖情况。结果:在治疗第1个月结束时,研究组一过性低血压(31.91%)、皮疹(29.79%)、剥脱性皮炎(12.77%)的发生率高于对照组,差异有统计学意义(P<0.05),两组从困倦嗜睡、头晕头痛的发生率比较,差异无统计学意义(P>0.05)。在治疗第6个月结束时,两组癫痫发作次数、癫痫积分、STESS评分均低于治疗前,差异有统计学意义(P<0.05),组间差异无统计学意义(P>0.05)。研究组呼吸抑制(17.02%)、肝功能异常(19.15%)、白细胞水平降低(14.89%)的发生率高于对照组,差异有统计学意义(P<0.05),两组从蓄积中毒反应发生率比较,差异无统计学意义(P>0.05)。两组患儿药物耐受良好,均未出现加量情况,研究组BDEPQ评分高于对照组,差异有统计学意义(P<0.05)。结论:苯巴比妥和卡马西平用于治疗儿科癫痫部分性发作均能有效控制患儿的癫痫发作情况,但相对于卡马西平,苯巴比妥服药早期更易导致患儿出现一过性低血压、皮疹以及剥脱性皮炎,长期服用易导致呼吸抑制、肝功能异常以及白细胞水平降低,且产生较高的药物依赖。

Objective: To explore the safety of long-term use of phenobarbital in children with partial epilepsy. Methods: In this study, 96 children with partial epilepsy admitted to the pediatric clinic of the hospital from August 2019 to August 2020 were selected as the research objects. According to the random number table, they were divided into study group and control group, with 48 cases in each group. Both groups of children were treated with basic treatment intervention. On this basis, the study group was treated with phenobarbital and the control group was treated with carbamazepine. The course of treatment was 6 months. At the end of the first month of treatment, compare the early sequelae effects of the two groups of children;at the end of the sixth month of treatment, compare the treatment effects, long-term sequelae effects, drug tolerance and drug dependence of the two groups of children Happening. Results: At the end of the first month of treatment, the incidence of transient hypotension(31.91%), rash(29.79%), and exfoliative dermatitis(12.77%) in the study group was higher than that in the control group, and the difference was statistically significant(x^(2)= 4.506, 10.277, 4.230, P < 0.05). There was no significant difference in the incidence of drowsiness, drowsiness, dizziness and headache between the two groups(P>0.05). At the end of the 6 th month of treatment, the number of seizures, epilepsy scores, and STESS scores in the two groups were lower than before treatment, the difference was statistically significant(P<0.05), and the difference between the groups was not statistically significant(P>0.05). The incidence of respiratory depression(17.02%), abnormal liver function(19.15%), and decreased white blood cell levels(14. 89%) in the study group was higher than that in the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of cumulative poisoning between the two groups(P > 0.05). At the end of the 6 th month of treatment, the two groups of children were well tolerated with the drug, and there was no increase in the dose. The BDEPQ score of the study group was higher than that of the control group, and the difference was statistically significant(P<0.05). Conclusion: Both phenobarbital and carbamazepine in the treatment of pediatric partial seizures can effectively control the epileptic seizures of children, but compared with carbamazepine, phenobarbital is more likely to cause transients in the early stage of taking phenobarbital. Low blood pressure, skin rash, and exfoliative dermatitis, long-term use can easily lead to respiratory depression, abnormal liver function and lower white blood cell levels, and cause high drug dependence.