摘要
目的：观察按药物半衰期长短交替应用5种抗惊厥药物组成的改良亚冬眠疗法治疗重症病毒性脑炎引起癫痫持续状态的效果。方法：96例重症病毒性脑炎并发癫痫持续状态的患儿,按患儿家长意愿分为对照组和治疗组（经一致性检验,2组具有可比性）。对照组患儿给予抗惊厥、冰敷法物理降温及常规治疗。抗惊厥应用5种抗惊厥药：冬眠灵、非那根各0.5 mg·kg^-1,100 g·L^-1水合氯醛0.5 mL.kg^-1,鲁米那5 mg·kg^-1,安定0.3 mg·kg^-1,发生抽搐时交替给药,不抽搐时不给抗惊厥药。治疗组患儿在常规治疗的基础上,辅以改良亚冬眠疗法,抗惊厥采取与对照组相同药物及剂量,根据每种药半衰期的长短,依次每隔46 h交替给一种药,排好时间,不管是否发生抽搐,均连续给药2 d,以后解眠,逐渐撤去镇静药。观察2组患儿治疗有效率,症状、体征消失时间及用药安全性。结果：纳入的96例重症病毒性脑炎患儿全部进入结果分析。①治疗有效率及安全性：治疗组的治疗总有效率明显高于对照组（χ^2=5.872,P〈0.05）。所有患儿均未发生呼吸抑制,未观察到明显副作用。②症状、体征消失时间：治疗组患儿惊厥、发热、头痛、呕吐的恢复时间与对照组比较明显缩短（P〈0.05）;癫痫持续状态症状明显减轻。治疗组患儿肢瘫、昏迷、失语的恢复时间也明显短于对照组（P〈0.05）。结论：改良亚冬眠疗法治疗小儿重症病毒性脑炎引起的癫痫持续状态,治疗效果确切,安全性好。
Objective To observe the therapeutic effect of reformed subhibernation therapy on status epilepticus in patients with severe viral encephalitis.Methods 96 children with severe viral encephalitis complicated by status epilepticus were randomly divied into control group and experimental group.Control group： routine treatment was given that includes anticonvulsivus,ice compress and conventional therapy.The anticonvulsivus was applied in five drugs： the same doses of wintermin and phenergan mixed up,10% chlorpromazine hydrochloride,luminal,valii,the drugs were delivered when convulsion occurred otherwise not.Experimental group： in addition to routine treatment reformed subhibernation therapy was given.The anticonvulsivus drug＇s was delivered in return each 4-6 h according to the drugs half life.And anticonvulsivus drugs were applied for 2 d then gotten off.The clinical manifestation,auxiliary examination and therapeutic efficacy of patients in two groups were observed.Results All of 96 cases were analyzed.The lotal effective rate in experimental group is higher than that in control group（χ^2=5.872,P〈0.05）.All the patients had no respiratory suppression.There was no obviously side effect in two groups.The recovery time of epilepticus,fever,headache and vomition in experimental group was significanly shorter than those in control group（P〈0.05）.The symptoms of status epilepticus in experimental group was obviously alleviated.The recovery time of paralysis of limb,coma and aphasia of patients in experimental group was shorter than that in control group（P〈0.05）.Conclusion The therapeutic effect of reformed subhibernation therapy on staturs epilepticus in patients with severe viral encephalitis is clear and safe.
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2009年第5期928-931,共4页
Journal of Jilin University：Medicine Edition
基金
中国第四十届博士后科学基金资助课题(20060400893)
关键词
改良亚冬眠
重症病毒性脑炎
癫痫持续状态
reformed subhibernation therapy
severe viral encephalitis
status epilepticus
