补充抗癫痫治疗对心肺复苏后有脑电癫痫持续状态患者的临床疗  

Clinical effect of supplementary antiepileptic therapy on patients with electroencephalogram epileptic status after cardiopulmonary resuscitation

作　　者：关彦钧[1] 张旺龙[2] 黄光锐[1] Guan Yanjun;Zhang Wanglong;Huang Guangrui(Department of Emergency,Kaiping Central Hospital,Kaiping 529300,China;Department of Critical Care Medicine,Kaiping Central Hospital,Kaiping 529300,China)

机构地区：[1]开平市中心医院急诊科,广东开平529300 [2]开平市中心医院重症医学科,广东开平529300

出　　处：《中华脑科疾病与康复杂志（电子版）》2019年第6期360-363,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：江门市卫生计生局科学技术研究项目(19A091)。

摘　　要：目的探讨补充抗癫痫治疗对心脏骤停复苏成功后有脑电癫痫状态患者的临床疗效。方法选择开平市中心医院自2016年1月至2018年12月收治的31例心脏骤停复苏成功后有脑电癫痫持续状态的患者作为研究对象,进行随机对照研究。根据随机数字表法分为观察组(17例)和对照组(14例),在心肺复苏(CPR)规范化治疗的基础上,观察组给予抗癫痫药物治疗,达到癫痫状态的完全控制,对照组则给予常规镇静治疗。比较2组患者在临床治疗指标(CPR时间、电除颤使用情况、ICU住院时间、机械通气时间、癫痫复发率),以及神经-精神功能预后[脑功能评分(CPC)、生活质量评价量表SF-36评分(SF-36)、蒙特利尔认知功能评估量表(MoCA)评分、蒙哥马利和阿斯伯格抑郁量表(MADRS)评分]方面的差异。结果2组患者CPR用时、电除颤使用、机械通气时间、出院时GOS评分差异无统计学意义(P>0.05);观察组患者的ICU治疗时间短于对照组,癫痫复发率、CPC评分平均秩、MADRS评分小于对照组,SF-36评分、MoCA评分高于对照组,差异具有统计学意义(P<0.05)。结论对于心脏骤停复苏成功后有脑电癫痫持续状态患者,补充抗癫痫治疗可以缩短ICU治疗时间,降低癫痫复发率,并有效改善患者的神经-精神预后状况。Objective To investigate the clinical effect of supplementary antiepileptic therapy on electroencephalogram epileptic status in patients with successful resuscitation after cardiac arrest.Methods Thirty-one patients with status epilepticus after cardiac arrest and obtained successful cardiopulmonary resuscitation(CPR)admitted to Kaiping Central Hospital from January 2016 to December 2018 were selected as the study subjects for a randomized controlled study.According to the random number table method,the patients were divided into the observation group(17 cases)and the control group(14 cases).On the basis of standardized treatment of CPR,the observation group was given supplementary antiepileptic drug therapy to achieve control of epileptic state,while the control group was given conventional sedation treatment.The differences of clinical therapeutic indexes(CPR available time,use of electrical shock,mechanical ventilation,ICU length of hospital stay,recurrence time,epilepsy)and prognosis of neuro-psychiatric outcomes[cerebral performance category(CPC),quality of life assessment scale SF-36 score(SF-36),Montreal cognitive assessment(MoCA),Montgomery and Asberg depression rating scale(MADRS)score]between the two groups were compared.Results There were no statistically significant differences in CPR duration,electric defibrillation use,mechanical ventilation duration,and GOS score at discharge time between the two groups(P>0.05).ICU treatment time and epilepsy recurrence rate of patients in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The average rank of CPC score and MADRS score in the observation group were smaller than those in the control group,with statistically significant differences(P<0.05),while the SF-36 score and MoCA score were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Supplementing antiepileptic therapy can shorten the treatment time in ICU,reduce the rate of epileptic recurr

关 键 词：抗癫痫治疗 心肺复苏 神经-精神预后 癫痫持续状态 

分 类 号：R742.1[医药卫生—神经病学与精神病学]