丙戊酸钠静脉注射治疗癫痫持续状态

Intravenous sodium valproate in treatment of status epilepticus

目的 :探讨丙戊酸钠注射液治疗癫痫持续状态的疗效和安全性。方法 :丙戊酸钠组 (n =19)和地西泮组 (n =2 2 ) ,均在负荷量丙戊酸钠 10～ 15mg·kg- 1或地西泮 10～ 2 0mg推注后 ,继续 2 4h维持治疗 (分别为 1mg·kg- 1·h- 1和 0 .1～ 0 .2mg·kg- 1·h- 1) ,观察其抗癫痫状态的疗效和不良反应。结果 :丙戊酸钠组和地西泮组起效时间为 (2 3±s18)min和 (7± 5 )min(P <0 .0 1) ,有效率分别为4 7%和 73% (P >0 .0 5 )。丙戊酸钠对不同的癫痫状态类型的疗效无显著差异 (P >0 .0 5 )。丙戊酸钠组治疗前后的生命体征无明显变化 ,血、尿常规 ,肝、肾功能及心电图也无明显改变 ,癫痫状态控制后 ,意识恢复较地西泮组快。结论 :丙戊酸钠注射液治疗癫痫状态有效 。

AIM: To investigate the efficacy and safety of intravenous sodium valproate therapy in the patients with status epilepticus. METHODS:Nineteen patients in intravenous sodium valproate group and twenty-two patients in diazepam group received a loading dose (sodium valproate 10-15 mg·kg -1 or diazepam 10-20 mg) and then a continuous infusion (sodium valproate 1 mg·kg -1·h -1 or diazepam 0.1-0.2 mg·kg -1·h -1) for 24 h.The effect and adverse reactions were observed. RESULTS: Clinical status epilepticus stopped in nine of nineteen patients(47%) in intravenous sodium valparoate group and sixteen of twenty-two patients(73%) in diazepam group. There was no significant difference(P> 0.05). Status epilepticus interrupted in (23±18) min in intravenous sodium valproate group and (7±5) min in diazepam group, respectively(P< 0.05). The effects of sodium valproate for different types of status epilepticus were not different(P> 0.05). All patients were closely monitored during and after sodium valproate infusion. There were no changes of vital sign, blood and urine routine, kidney and liver function, and ECG. Consciousness recovered more rapidly in sodium valproate group than that in diazepam group. CONCLUSION:Intravenous sodium valproate seems safe and effective for the status epilepticus, especially for status epilepticus patients with critical ills.