碳青霉烯类药物联合卡马西平或左乙拉西坦治疗重症感染合并癫痫患者的临床研究

Clinical study of carbapenem drugs combined with carbamazepine or levetiracetam in the treatment of patients with severe infections and epilepsy

目的分析在重症感染合并癫痫患者中应用碳青霉烯类药物联合卡马西平或左乙拉西坦治疗的效果。方法从廉江市人民医院诊疗的重症感染合并癫痫患者(2021年5月-2023年12月)中选出60例作为研究对象,按随机数字表法将60例分为每组都是30例的对照组和观察组,两组均接受碳青霉烯类药物治疗,在此基础上,对照组予以卡马西平治疗,观察组予以左乙拉西坦治疗。对比两组每日癫痫发作次数、癫痫发作持续时间、两次发作间隔时间,统计两组用药不良反应和临床总有效率。结果观察组临床总有效率(96.67%)比对照组(83.33%)高(P<0.05);观察组不良反应发生率(3.33%)比对照组(20.00%)低(P<0.05);治疗后观察组每日癫痫发作次数少于对照组,癫痫发作持续时间短于对照组,两次发作间隔时间长于对照组(P<0.05)。结论在重症感染合并癫痫患者中应用碳青霉烯类药物联合卡马西平或左乙拉西坦治疗均有一定效果,但与左乙拉西坦联合的效果更佳,在控制感染的同时能有效改善癫痫相关症状,减少发作次数,安全性更高。

Objective To explore and analyze the efficacy of carbapenems combined with carbamazepine or levetiracetam in the treatment of patients with severe infection and epilepsy.Method Sixty patients with severe infection combined with epilepsy diagnosed and treated at the People's Hospital of Lianjiang City(May 2021 December 2023)were selected as the study subjects.They were randomly divided into a control group and an observation group,each consisting of 30 cases,using a random number table method.Both groups received treatment with carbapenems.On this basis,the control group received treatment with carbamazepine,while the observation group received treatment with levetiracetam.Compare the daily number of seizures,duration of seizures,and interval between two seizures between two groups,and calculate the adverse drug reactions and clinical total effective rate between the two groups.Results The clinical total effective rate comparison showed that the observation group(96.67%)was higher than the control group(83.33%)(P<0.05);the incidence of adverse reactions in the observation group(3.33%)was lower than that in the control group(20.00%)(P<0.05);after treatment,the observation group had fewer daily epileptic seizures than the control group,and the duration of epileptic seizures was shorter than that of the control group,the interval between the two seizures was longer than that of the control group(P<0.05).Conclusion The use of carbapenems combined with carbamazepine or levetiracetam in the treatment of patients with severe infection and epilepsy has certain effects,but the combination with levetiracetam is more effective.It can effectively improve epilepsy related symptoms,reduce the number of seizures,and have higher safety while controlling infection.