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目的探讨亚高原高血压脑出血后预防癫痫治疗方法,降低继发癫痫的发生率。方法回顾性分析我院2012年6月至2016年2月确诊为高血压脑出血患者443例,其中癫痫发作8例,早期癫痫发作7例。所有高血压脑出血患者采用预防癫痫治疗(早期持续微泵丙戊酸钠注射液+依达拉奉注射液);针对癫痫发作患者,癫痫发作时立即静脉推注安定,持续状态时予以微泵咪达唑仑,微泵丙戊酸钠注射液7d后改为口服或鼻饲药物3个月;迟发性癫痫和复发癫痫正规抗癫痫治疗。结果高血压脑出血后继发性癫痫发生率1.81%,明显低于云南省亚高原部分医院继发性癫痫发生率(P<0.05);脑出血继发癫痫治疗后复发3例,复发率37.5%。结论亚高原高血压脑出血患者早期通过规范化预防癫痫治疗,可以降低癫痫发生率。
Objective To explore the methods of preventing epilepsy after subhypertensive hypertensive intracerebral hemorrhage and to reduce the incidence of secondary epilepsy. Methods A retrospective analysis of our hospital from June 2012 to February 2016 were diagnosed as hypertensive intracerebral hemorrhage in 443 patients, including 8 cases of seizures, early seizures in 7 cases. All patients with hypertensive intracerebral hemorrhage were treated with prophylaxis of epilepsy (early continuous micro-pump sodium valproate injection and edaravone injection); for patients with seizures, intravenous bolus injection of sevoflurane during seizure and micro pump Midazolam, sodium pump valproate injection 7d after oral or nasal feeding drugs for 3 months; delayed epilepsy and recurrent epilepsy regular anti-epileptic treatment. Results The incidence of secondary epilepsy after hypertensive intracerebral hemorrhage was 1.81%, which was significantly lower than that of some epilepsy in sub-plateau in Yunnan Province (P <0.05). Three cases recurred after intracerebral hemorrhage epilepsy, the recurrence rate was 37.5% . Conclusion Subhypertensive patients with hypertensive intracerebral hemorrhage through early standardized treatment of epilepsy can reduce the incidence of epilepsy.