论文部分内容阅读
当静注最大剂量的苯妥因和苯巴比妥能控制SE(癫痫持续状态)时,传统需静注巴比妥类药物如戊巴比妥进行全麻。尽管利用“PBC(戊巴比妥昏迷)”法有很强的控制SE的作用,然而大多数患者会出现系统性低血压,而需要升压药和的治疗;另外,用戊巴比妥治疗SE死亡率也较高。因此作者试用大剂量IV LZP(静脉注射氯羟去甲安定)治疗9例次严重的难治性SE,作为可能替代戊巴比妥而无毒性作用的药物。 8例SE患者共治疗9次。在IV LZP之前,所有病例处于SE至少持续1天。4例全身型抽搐发作;4例部分复杂性发作伴意识丧失和局灶性抽搐,其中1例患者有2次SE发作;1例既表现为全身型抽搐发作又有部分复杂性发作。
When the maximum intravenous infusion of phenytoin and phenobarbital can control the SE (status epilepticus), the traditional intravenous barbiturates such as pentobarbital anesthesia. Although the use of “PBC (pentobarbital coma)” law has a strong effect on the control of SE, however, most patients develop systemic hypotension requiring vasopressor therapy. In addition, treatment with pentobarbital SE mortality is also higher. Therefore, the authors tried a large dose of IV LZP (intravenous chloroquel and methotrexate) in the treatment of 9 patients with severe refractory SE as a possible non-toxic alternative to pentobarbital. Eight patients with SE were treated 9 times. All cases were in SE for at least 1 day prior to IV LZP. 4 cases of generalized convulsive seizures; 4 cases of partial complication associated with loss of consciousness and focal convulsions, of which 1 case had 2 episodes of SE; 1 case showed both systemic seizures and some complicated seizures.