王首杰　高国栋　秦淮洲

[摘要] 目的 探讨丙戊酸钠注射液、依达拉奉及两者联合应用对创伤性癫痫预防的不同效果。 方法 将930例创伤性脑损伤患者随机分为丙戊酸钠注射液组、依达拉奉组、联合组，分别在入院后给予丙戊酸钠注射液、依达拉奉、丙戊酸钠注射液和依达拉奉联合用药，进行24个月的随访，观察各组患者创伤性癫痫的发生情况，利用SPSS 19.0软件分析数据。 结果 丙戊酸钠注射液组、依达拉奉组、联合组早期创伤性癫痫发生率分别为4.07%、9.71%、4.01%，丙戊酸钠注射液组、联合组早期癫痫发生率明显低于依达拉奉组（P<0.01），联合组早期癫痫发生率与丙戊酸钠注射液组差异无统计学意义（P>0.900）；丙戊酸钠注射液组、依达拉奉组、联合组晚期创伤性癫痫发生率分别为9.74%、8.64%、3.69%，联合组晚期癫痫发生率明显低于丙戊酸钠注射液组（P<0.01），依达拉奉组晚期癫痫发生率与丙戊酸钠注射液组、联合组差异无统计学意义（P>0.500、P>0.025）。 结论 依达拉奉对于早期创伤性癫痫的预防作用较差，联合应用依达拉奉与丙戊酸钠注射液对于晚期创伤性癫痫的预防有良好作用。

[关键词] 颅脑创伤；创伤性癫痫；丙戊酸钠注射液；依达拉奉

[中图分类号] R971+.6 [文献标识码] A [文章编号] 1674-4721（2014）04（b）-0031-04

[Abstract] Objective To compare the preventive effects of sodium valproate for injection，edaravone and the combination of the two drugs on traumatic epilepsy.Methods 930 cases of patients with traumatic brain injury were randomly divided into sodium valproate for injection group，edaravone group and the combined group，which were given sodium valproate for injection，edaravone and combination of the two drugs respectively.Patients were followed up for 24 months and clinical signs of seizures were observed.The SPSS 19.0 software was used to analyze the data.Results The rate of traumatic epilepsy at the early stage in sodium valproate for injection group，edaravone group and combined group was 4.07%，9.71%，4.01% respectively.Sodium valproate for injection group and combined group was lower than that of edaravone group （P<0.01） and there was no significant difference between sodium valproate for injection group and the combined group （P>0.900）.The rate of traumatic epilepsy at the later stage in sodium valproate for injection group，edaravone group and combined group was 9.74%，8.64%，3.69% respectively.Combined group was lower than that of sodium valproate for injection group （P<0.01）.There was no difference between edaravone group and sodium valproate for injection group （P>0.500），the combined group （P>0.025）.Conclusion Edaravone is lack of effect on protection patients from early traumatic epilepsy.Combined with sodium valproate for injection，edaravone has a better preventive effect on late traumatic epilepsy.

[Key words] Traumatic brain injury；Traumatic epilepsy；Sodium valproate for injection；Edaravone

创伤性癫痫即创伤性脑损伤后出现的癫痫反复发作，是颅脑创伤后最严重的并发症之一，也是症状性癫痫中最常见的一种类型。创伤性脑损伤后，癫痫发作分为即刻创伤性癫痫（<24 h）、早期创伤性癫痫（1～7 d）和晚期创伤性癫痫（>7 d）[1]。创伤性脑损伤发生后，如果不进行预防性干预，早期创伤性癫痫发生率为4%～25%，晚期创伤性癫痫发生率为9%～42%[2-3]。

多数研究显示创伤性脑损伤后预防性应用抗癫痫药可以降低早期创伤性癫痫发病率，但对晚期创伤性癫痫发病率无影响，如Temkin等[4]的一项随机双盲对照临床研究表明，创伤性脑损伤后预防性应用抗癫痫药可将早期创伤性癫痫发病率由14.2%降至3.6%；某……