腦血管病繼發(fā)癲癇病的臨床研究

[摘要] 目的 評價藥物治療腦血管病繼發(fā)癲癇療效，分析疾病發(fā)病特征，總結(jié)治療經(jīng)驗。方法 方便選取2014年2月—2016年1月，神經(jīng)內(nèi)科收治的腦血管病繼發(fā)癲癇患者作為研究對象，入選對象72例，隨機(jī)對照分組，對照組、觀察組各入組36例，兩組患者均治療原發(fā)卒中病、康復(fù)治療，癲癇發(fā)作時，部分給予鎮(zhèn)定劑，對照組選擇抗癲癇藥物CBZ、OXC、VPA、VLA治療，單用或聯(lián)用，觀察組聯(lián)合或單獨應(yīng)用左乙拉西坦治療，24周為1個療程，進(jìn)行視頻腦電圖檢查，評價治療效果。結(jié)果 觀察組控制率25.0%、控制+顯效合計率80.6%高于對照組2.8%、33.33%，無效率11.1%低于對照組33.3%，差異均有統(tǒng)計學(xué)意義（P<0.05）；治療后，觀察組與對照組癲癇放電指數(shù)低于治療前，觀察組低于對照組，差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 腦血管病繼發(fā)癲癇病多見腦葉區(qū)損傷者，多表現(xiàn)為強(qiáng)制-痙攣發(fā)作、單純部分性發(fā)作；常規(guī)抗癲癇藥物療效常難以讓人滿意，左乙拉西坦療效較好。

[關(guān)鍵詞] 癲癇；腦血管病；繼發(fā)病；臨床治療

[中圖分類號] R4 [文獻(xiàn)標(biāo)識碼] A [文章編號] 1674-0742（2016）11（a）-0088-03

[Abstract] Objective To evaluate the drug in the treatment of cerebral vascular disease and secondary epilepsy disease characteristics， summarize the treatment experience. Methods Convenient selection from February 2014 to January 2016， Department of neurology were cerebral vascular disease and secondary epilepsy patients as the research object， selected 72 cases， as control group， the control group， the observation group and the group of 36 cases， two groups of patients were treated for primary stroke， rehabilitation treatment， seizures， given tranquilizer， and the control group， select the antiepileptic drug carbamazepine（CBZ）， OXC， VPA， VLA treatment， Single or combined use， the observation group joint or separate application of levetiracetam therapy， 24 weeks A period of video EEG， and the treatment effect was evaluated. Results Observation group control rate of 25.0%， control + effective total rate is 80.6% higher than that of the control group 2.8%，33.33%，11.1% efficiency is lower than that of the control group was 33.3%， differences were statistically significant （P < 0.05）； after treatment， observation group and the control group of epileptic discharge index were lower than those before treatment， observation group than that in the control group， the difference is statistically significant（P < 0.05）. Conclusion Cerebral vascular disease and secondary epilepsy disease more common lobe of brain damage， more performance for the forced seizures， simple partial seizures； routine antiepileptic Drug efficacy is often difficult to make people satisfied， good curative effect of levetiracetam.

[Key words] Epilepsy； Cerebral vascular disease； Incidence； Clinical treatment

癲癇是一種慢性腦功能障礙綜合征，我國發(fā)病率約為0.5‰～0.7‰，腦血管病是繼發(fā)性癲癇常見病因，發(fā)病率約為1%～20%[1]。癲癇危害較大，患者以癲癇樣為主要表現(xiàn)，發(fā)作時患者可因喪失意識狀態(tài)，無法自控，易出現(xiàn)跌倒、窒息，癲癇嚴(yán)重?fù)p害患者生存質(zhì)量，患者基本喪失勞動能力，給家庭帶來沉重的照料負(fù)擔(dān)[2]。癲癇易反復(fù)發(fā)作，治療難度大，復(fù)發(fā)率高，有報道顯示約20%～30%的患者進(jìn)展為難治性癲癇。深入分析腦血管病繼發(fā)性癲癇病臨床特點，總結(jié)診治經(jīng)驗非常必要。……