麦玉珍　李踔　占婷婷

[摘要]目的 探讨左乙拉西坦联合丙戊酸钠注射液治疗癫痫持续状态的效果及安全性。方法 选取我院神经内科2010年6月～2016年12月收治的105例癫痫持续状态患者为研究对象，随机分为对照组52例实施丙戊酸钠注射液治疗，试验组53例实施左乙拉西坦联合丙戊酸钠注射液治疗。比较两组的总有效率、发作控制率、发作控制时间、起效时间、复发率和不良反应发生率。结果 治疗后，试验组的总有效率、发作控制率显著高于对照组（P<0.05）；试验组的发作控制时间、起效时间明显短于对照组（P<0.05）；试验组的复发率、不良反应率显著低于对照组（P<0.05）。结论 左乙拉西坦联合丙戊酸钠注射液治疗癫痫持续状态的效果显著，可有效控制大脑神经元癫性放电，减少癫痫发作次数，降低不良反应发生率，具有临床应用价值。

[关键词]左乙拉西坦；丙戊酸钠注射液；癫痫持续状态；效果；安全性

[中图分类号] R742.1 [文献标识码] A [文章编号] 1674-4721（2017）08（a）-0033-03

[Abstract]Objective To evaluate the safety and efficacy of Levetiracetam combined with Valproate Sodium Injection in the treatment of status epilepticus.Methods 105 patients with status epilepticus treated in department of internal medicine-neurology of our hospital from June 2010 to December 2016 were selected as the research object，and they were randomly divided into control group 52 cases with intravenous Sodium Valproate Injectiontreatment，while 53 cases of experimental group with implementation of Levetiracetam combined with Valproate Sodium Injection.The total effective rate，seizure control rate，seizure control time，onset time，recurrence rate and incidence of adverse reactions between the two groups were compared.Results After the treatment，the total effective rate of the experimental group，seizure control rate was significantly higher than the control group （P<0.05）.The onset time and control time of the experimental group were significantly shorter than the control group （P<0.05），and the recurrence rate，adverse reaction rate of the experimental group were significantly lower than those of the control group （P<0.05）.Conclusion Levetiracetam combined with Sodium Valproate Injection in the treatment of status epilepticus has a significant effect.It can effectively control the epileptiform discharges，reduce the number of episodes and incidence of adverse reactions.The treatment of Levetiracetam combined with Valproate Sodium Injection has a clinical application value.

[Key words]Levetiracetam；Valproate Sodium Injection；Status epilepticus；Efficacy；Safety

癲痫持续状态（status epilepticus，SE）又称为癫痫状态，临床定义为癫痫连续性发作时，意识未完全恢复又频繁再发，或者发作时间持续≥30 min无法自行停止[1]。SE由机体内异常放电的及时补位与传递方式呈现不同，癫痫的发作形式与原因也呈复杂化、多样化。治疗中通过正规抗癫痫药物治疗，约占70%的患者癫痫发作可以控制，这其中50%～60%的患者经过2～5年的持续性治疗，最终可与正常人一样工作与生活[2]。据相关调查显示，一旦癫痫发作时间过长，机体内环境的稳定被破坏进入失代偿期，常规抗痫药物无法完全控制发作，势必发展为SE，引起大脑水肿加重，脑细胞缺血缺氧严重，造成中枢神经系统不可逆损害，具有较高致残率及死亡率[3]，因此，紧急治疗、稳定生命体征、迅速控制癫痫发作成为临床抢救SE的重点和难点。迅速起效的抗癫痫药物组合方案作为抢救成功的关键，越来越受到医学界的关注。……