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[摘要]
目的 观察奥氮平联合丙戊酸钠治疗难治性癫痫持续状态的临床效果。方法 采用回顾性、随机对照研究方法,将2015年2月—2017年9月在遂宁市中心医院诊治的难治性癫痫持续状态患者190例分为观察组与对照组各95例,对照组给予丙戊酸钠治疗,初剂量为5~10 mg/(kg·d),然后每周增加剂量5~10 mg/(kg·d),持续增加到剂量为20~30 mg/(kg·d)后进行维持治疗。观察组在对照组治疗的基础上给予奥氮平6 mg治疗,1次/d。两组都治疗观察4周。比较两组近期疗效、不良反应及认知功能情况。结果 观察组与对照组的总有效率分别为98.9%和88.4%,观察组明显高于对照组,差异有统计学意义(P<0.05)。观察组的不良反应发生率4.2%与对照组(6.3%)无统计学差异。两组治疗后的简易精神状态检查量表(MMSE)评分均明显高于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的MMSE评分明显高于对照组,组间差异有统计学意义(P<0.05)。结论 奥氮平联合丙戊酸钠治疗难治性癫痫持续状态能提高治疗效果,不会增加不良反应的发生,能促进患者认知功能的改善,有很好的应用效果。
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[Abstract]
Objective To observe the clinical effects of olanzapine combined with valproate in the treatment of refractory status epilepticus. Methods Use a retrospective, randomized study method, From February 2015 to September 2017, 190 patients of intractable epilepsy with persistent state in our hospital diagnosis and treatment were selected as the research object and were divided into study group and control group with 95 patients in each group accorded to the different treatment methods. The control group was given sodium valproate treatment, the study group was given olanzapine treatment based on the control group treatment, two groups were treated for four weeks.Results The total effective rates in the study group and the control group were 98.9% and 88.4% respectively, and the study group was significantly higher than the control group (P<0.05). The incidence of adverse reactions in the study group was 4.2 percent (4/95) and the control group was 6.3% (6/95) with no statistical difference. MMSE scores of both groups were higher than those before treatment, and the MMSE score of the study group was higher than that in the control group (P<0.05). Conclusion Olanzapine combined with valproate in the treatment of refractory status epilepticus can improve the therapeutic effect, do not increase the occurrence of adverse reactions, and improve the cognitive function of patients. So it has a good application effects.
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