左乙拉西坦预防成人外伤性癫痫的临床研究

发布时间：2018-04-10 06:04

本文选题：癫痫　切入点：创伤后　出处：《中华脑科疾病与康复杂志(电子版)》2015年05期

【摘要】：目的评估左乙拉西坦(LEV)对成人急性颅脑外伤患者晚期癫痫发作(LPTE)的发生率及认知功能变化的影响。方法选取山西医科大学第一医院神经外科和急诊科2013年5至12月住院的成人颅脑外伤患者95例,并将其随机分为三组:A组,30例患者给予口服LEV,500 mg/次,2次/d;B组,32例患者给予口服丙戊酸缓释片,500 mg/次,1次/d;C组,33例作为对照组,未服抗癫痫药物。观察三组患者随访一年的癫痫发生率与脑电图情况,使用简易智力状况检查法(MMSE)量表评价患者的认知情况。结果三组患者一年内LPTE累计发生率分别为3.33%、12.50%、15.63%。A组LPTE的发生率低于B组和C组,差异有统计学意义(PA-B=0.031,PA-C=0.017),B组LPTE的发生率低于C组,但差异无统计学意义(P0.05)。A组患者用药前后的脑电图有差别,差异有统计学意义(P=0.025),B组和C组患者用药前后的脑电图差异无统计学意义(均P0.05)。A组用药前后MMSE量表评分改善程度和B组、C组比较,差异无统计学意义(均P0.05)。结论 LEV具有较好的预防外伤后癫痫发生的作用,且可以改善患者的脑电图情况。
[Abstract]:Objective to evaluate the effect of levoethiracetam (Levo) on the incidence and cognitive function of LPTEs in adult patients with acute craniocerebral trauma.Methods 95 adult patients with craniocerebral trauma were selected from the Department of Neurosurgery and Emergency Department of the first Hospital of Shanxi Medical University from May to December 2013.They were randomly divided into three groups: group A (n = 30) and group B (n = 32) were given oral Levamethasone 500 mg/ twice times / d group (n = 32), group C (n = 33) were treated with oral valproic acid sustained release tablet (500 mg/) once a time, and 33 cases in group C (n = 33) were treated with antiepileptic drugs.The incidence of epilepsy and electroencephalogram (EEG) were observed and the cognitive status of the patients was evaluated by MMSE scale.Results the cumulative incidence of LPTE in group A was lower than that in group B and group C, and the incidence of LPTE in group B was lower than that in group C. The incidence of LPTE in group B was lower than that in group C.However, there was no significant difference in electroencephalogram (EEG) of patients in group P0.05A before and after medication.There was no significant difference in EEG between group B and group C before and after treatment (P 0.05). There was no significant difference between group B and group C in the improvement of MMSE scale score before and after treatment (all P 0.05), and there was no significant difference between group B and group C (P 0.05).Conclusion LEV can prevent the occurrence of post-traumatic epilepsy and can improve the EEG of the patients.
【作者单位】：山西医科大学第一医院神经内科;山西省人民医院神经内科;
【分类号】：R742.1

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