癫痫持续状态的药物治疗.pptVIP

短期危害 长期危害 * Flow chart of status epilepticus treatment. Increasing refractoriness is illustrated by the background color intensity; the non-sedating agents are green, anesthetics in orange to red, and other options in yellow or white. First-line treatment is light green, second-line darker green, and third line light and darker orange. Other options are given in red, yellow and blue. * 用法简单，禁忌症少，不需要心脑检测 * * 【43】Intravenous sodium valproate versus diazepam infusion for the control of refractory status epilepticus in children: a randomized controlled trial An open-label, randomized controlled study was conducted at a tertiary care teaching hospital to compare efficacy and safety of intravenous sodium valproate versus diazepam infusion for control of refractory status epilepticus. Forty children with refractory status epilepticus were randomized to receive either intravenous sodium valproate or diazepam infusion. Refractory status epilepticus was controlled in 80% of the valproate and 85% of the diazepam patients. The median time to control refractory status epilepticus was less in the valproate group (5 minutes) than the diazepam group (17 minutes; P .001). None of the patients in the valproate group required ventilation or developed hypotension, whereas in the diazepam group 60% required ventilation and 50% developed hypotension after starting diazepam infusion. No adverse effects on liver functions were seen with valproate. It is concluded that intravenous sodium valproate is an effective alternative to diazepam infusion in controlling refractory status epilepticus in children and is free of respiratory depression and hypotension * 用药方法： 19人 初始静脉注射15mg/kg, 静滴速度为1mg/kg/h，平均血浓度达到 65 mg/l 4人 初始静脉注射12mg/kg, 静滴速度为0.5mg/kg/h，平均血浓度为50 mg/l 结果：83％的患者在20分钟内SE消失，其中11例有效的全身性癫痫持续状态有10例在12分钟内消失，8例有效的部分性癫痫持续状态中有6例在12分钟内消失。丙戊酸钠针剂12分钟内能控制70％的癫痫持续状态，且安全性高，无镇静作用，未见其他不良反应。 起效快，安全性高 12分钟内能控制70%的癫痫持续状态 患者意识水平无影响，未见呼吸和心血管影响 治疗后第7天，实验室检查未见血液或肝功能衰竭 * Sixty-eight patients with convulsi