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目的:探讨脑血管病继发癫痫患者的临床特点和治疗方法。方法:我科对20例脑血管病继发癫痫患者:(1)迅速控制癫痫发作,首选地西泮10~20 mg静脉注射,无效时可重复一次;发作控制后用苯巴比妥钠针0.2~0.4 g/d,肌肉注射;频繁发作者给予地西泮60~100 mg加入5%葡萄糖注射液500 mL中12 h内缓慢静脉滴注,或苯妥英钠0.3~0.6 g加生理盐水500 mL中静脉滴注等。(2)积极治疗原发病,如降颅压、控制脑水肿、改善脑循环和供氧;防治并发症、维持营养及水电解质平衡等。结果:单纯部分性发作5例(25%),复杂部分性发作7例(35%),由单纯部分性发作转为强直阵挛发作5例(25%),癫痫持续状态3例(15%)。结论:癫痫是脑血管病的常见并发症,早期诊断、及时控制发作和综合治疗可减少死亡率。
Objective: To investigate the clinical features and treatment of patients with epilepsy secondary to cerebrovascular disease. Methods: In our department, 20 cases of patients with epilepsy with cerebrovascular disease were treated: (1) rapid control of seizures, intravenous injection of 10 ~ 20 mg of diazepam was the first choice and repeated once the drug was ineffective; after seizure control, sodium phenobarbital needle 0.2 ~ 0.4 g / d, intramuscular injection; Frequent seizures were given diazepam 60 ~ 100 mg 5% glucose injection 500 mL slow intravenous infusion within 12 h, or phenytoin 0.3 ~ 0.6 g plus saline 500 mL Such as intravenous drip. (2) active treatment of the primary disease, such as reducing intracranial pressure, cerebral edema control, improve cerebral circulation and oxygen; prevention and treatment of complications, nutrition and water and electrolyte balance maintained. Results: Simple partial seizures occurred in 5 cases (25%) and complicated partial seizures in 7 cases (35%), from simple partial seizures to tonic-clonic seizures in 5 cases (25%), status epilepticus in 3 cases (15% ). Conclusion: Epilepsy is a common complication of cerebrovascular disease. Early diagnosis, timely control of seizures and comprehensive treatment can reduce mortality.