颅脑创伤后预防性使用抗癫痫药物治疗的临床疗效分析及风险评估

Clinical Efficacy Analysis and Risk Assessment of Prophylactic Antiepileptic Drug Treatment after Craniocerebral Trauma

目的分析颅脑创伤患者预防性使用抗癫痫药物丙戊酸钠缓释片的临床效果及不良反应的风险评估。方法选择2021年2月—2022年1月如东县人民医院收诊接受药物治疗的颅脑创伤患者100例,根据奇偶抽签结果分作观察组(50例,奇数签)与对照组(50例,偶数签)。观察组给予丙戊酸钠缓释片0.5 g/次,2次/d,共2周,对照组不予口服抗癫痫药物。观察统计两组患者癫痫发生概率、血常规、肝肾功能异常率,对比分析两组患者治疗前后认知功能变化,统计两组患者不良反应发生概率。结果观察组患者癫痫发生率4.00%、血常规异常率2.00%、肝肾功能异常率4.00%均明显低于对照组,差异有统计学意义(χ^(2)=5.005、4.396、6.061,P<0.05)。入院时测定患者认知功能(定向、视知觉、空间知觉、动作运用、视运动组织时间、思维操作、注意力及专注力)评分差异无统计学意义(P>0.05);治疗后观察组评分均高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应总发生率差异无统计学意义(P>0.05)。结论颅脑创伤后患者给予预防性抗癫痫药物丙戊酸钠能够有效降低患者癫痫发生率,值得推广。

Objective To analyze the clinical effects and risk assessment of adverse reactions of prophylactic use of antiepileptic drug sodium valproate extended-release tablets in patients with craniocerebral trauma.Methods One hundred cases of craniocerebral trauma patients who were admitted to Rudong County People's Hospital for drug treatment from February 2021 to January 2022 were selected.They were divided into observation group(50 cases with odd number of sticks)and control group(50 cases with even number of sticks)according to the results of odd-even draw.The treatment group was given sodium valproate extended-release tablets 0.5 g/time,twice/d for a total of 2 weeks,and the control group was not given oral antiepileptic drugs.The probability of epilepsy,blood routine,liver and kidney function abnormality rate were observed and counted in both groups.The changes of cognitive function before and after treatment were compared and the incidence of adverse reactions in the two groups were counted.Results The incidence of epilepsy 4.00%,the rate of abnormal blood routine 2.00%,and the rate of abnormal liver and kidney function 4.00% were significantly lower in the observation group than in the control group,the difference was statistically significant(χ^(2)=5.005,4.396,6.061,P<0.05).There was no statistical difference in the scores of cognitive functions(orientation,visual perception,spatial perception,action use,visuomotor organization time,thought operations,attention and concentration)of patients measured at admission(P>0.05);the post-treatment scores were higher in the observation group than in the control group(P<0.05).There was no statistical difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion The administration of prophylactic antiepileptic drug sodium valproate to patients after craniocerebral trauma can effectively reduce the incidence of epilepsy in patients and is worth promoting.