不同剂量丙戊酸钠联合综合康复疗法治疗癫痫患儿的效果  

Effect of Different Doses of Sodium Valproate Combined with ComprehensiveRehabilitation Therapy on Children with Epilepsy

作　　者：郑丽丽[1] 康文芹 牛莎 ZHENG Lili;KANG Wenqin;NIU Sha(Department of Pediatrics,Jiaozuo People’s Hospital,Jiaozuo 454002,China)

机构地区：[1]焦作市人民医院儿科,河南焦作454002

出　　处：《河南医学研究》2023年第7期1267-1270,共4页Henan Medical Research

摘　　要：目的探讨综合康复疗法与不同剂量丙戊酸钠治疗癫痫患儿的效果及对认知功能的影响。方法回顾性分析2021年1月至2022年3月在焦作市人民医院诊治的118例原发性癫痫患儿,按照丙戊酸钠的使用剂量分为研究组(59例)和对照组(59例),两组均接受综合康复疗法治疗,研究组接受15 mg·kg^(-1)丙戊酸钠治疗,每间隔1周增加5 mg·kg^(-1),直至有效或者患儿不能耐受;对照组接受25 mg·kg^(-1)丙戊酸钠治疗,两组治疗时间均为6个月。比较两组临床疗效、治疗前后的认知功能和脑电图变化以及不良反应。结果研究组临床治疗总有效率(91.53%)与对照组(89.83%)比较,差异无统计学意义(P>0.05)。研究组丙戊酸钠使用剂量高于对照组(P<0.05)。治疗3、6个月两组蒙特利尔认知评估量表(MoCA)、韦克斯勒儿童智力量表(WISC)评分与治疗前比较均升高(P<0.05),治疗6个月两组MoCA、WISC评分与本组治疗3个月比较均升高(P<0.05),但治疗3、6个月两组MoCA、WISC评分比较,差异无统计学意义(P>0.05)。治疗6个月两组累及导联数、癫痫样放电与治疗前比较均降低(P<0.05),但研究组与对照组比较,差异无统计学意义(P>0.05)。研究组不良反应发生率(11.86%)低于对照组(35.59%)(P<0.05)。结论不同剂量丙戊酸钠分别联合综合康复疗法应用于癫痫患儿的疗效相当,均可有效改善认知功能,但先给予15 mg·kg^(-1)丙戊酸钠,再每周逐渐加量,不良反应更少。Objective To explore the effect of comprehensive rehabilitation therapy and different doses of valproate on children with epilepsy and its influence on cognitive function.Methods A retrospective analysis was made of 118 children with primary epilepsy who were treated in Jiaozuo People’s Hospital from January 2021 to March 2022.According to the dosage of sodium valproate,they were divided into 59 patients in the study group and 59 patients in the control group,and both group were treated with comprehensive rehabilitation therapy.The study group was treated with 15 mg·kg^(-1) sodium valproate,which was increased by 5 mg·kg^(-1) every 1 week until effective or the children could not tolerate it.The control group was treated with 25 mg·kg^(-1) sodium valproate,and the treatment time of both groups was 6 months.The clinical efficacy,cognitive function,EEG changes and adverse reactions of the two groups were compared before and after treatment.Results Compared with the control group(89.83%),the total effective rate of clinical treatment in the observation group(91.53%)was not statistically significant(P>0.05).The dosage of sodium valproate used in the observation group was higher than that in the control group(P<0.05).The Montreal cognitive assessment scale(MoCA)and Wexler children’s intelligence scale(WISC)scores in the two groups after 3 months and 6 months of treatment were all higher than those before treatment(P<0.05).The MoCA and WISC scores in the two groups were higher than those in the same group after 3 months of treatment(P<0.05),but there was no statistical difference in the MoCA and WISC scores between the two groups after 3 months of treatment and 6 months of treatment(P>0.05).After 6 months of treatment,the cumulative number of leads and epileptiform discharges in the two groups were decreased compared with those before treatment in the same group(P<0.05),but there was no statistical difference between the observation group and the control group(P>0.05).The incidence of adverse reactions in the ob

关 键 词：丙戊酸钠 综合康复疗法 癫痫患儿 认知功能 脑电图变化 

分 类 号：R742.1[医药卫生—神经病学与精神病学]