CAJ | 학술논문

目的：探讨单用丙泊酚、单用咪达唑仑和2者联用在难治性癫痫持续状态治疗中的疗效、不良反应等，以寻找较好的抗癫痫治疗方案。方法回顾性分析难治性癫痫持续患者75例。使用丙泊酚治疗的患者25例，使用咪达唑仑的患者25例，2药联合使用的患者25例。记录用药前、控制癫痫发作后、停药时这3个时点的心率（HR）、自主呼吸频率（RR）、收缩压（SBP）、舒张压（DBP）、血氧饱和度（SpO 2）以及治疗后镇静评级分数，癫痫控制起效时间以及不良反应的发生情况。结果联合用药组总体有效率为92.0%，显著高于丙泊酚组和咪达唑仑组的80.0%和84.0%（P<0.05）。3组患者用药前HR、RR、SBP、DBP、SpO 2与控制癫痫发作后、停药时所测得值相比，差异有统计学意义（P<0.05）；联合用药后，药物使用总量分别低于单独使用的组别，癫痫控制时间缩短，镇静分数提高（P<0.05）。结论丙泊酚及咪达唑仑2者联合抗癫痫的疗效优于单独使用。
목적：탐토단용병박분、단용미체서륜화2자련용재난치성전간지속상태치료중적료효、불량반응등，이심조교호적항전간치료방안。방법회고성분석난치성전간지속환자75례。사용병박분치료적환자25례，사용미체서륜적환자25례，2약연합사용적환자25례。기록용약전、공제전간발작후、정약시저3개시점적심솔（HR）、자주호흡빈솔（RR）、수축압（SBP）、서장압（DBP）、혈양포화도（SpO 2）이급치료후진정평급분수，전간공제기효시간이급불량반응적발생정황。결과연합용약조총체유효솔위92.0%，현저고우병박분조화미체서륜조적80.0%화84.0%（P<0.05）。3조환자용약전HR、RR、SBP、DBP、SpO 2여공제전간발작후、정약시소측득치상비，차이유통계학의의（P<0.05）；연합용약후，약물사용총량분별저우단독사용적조별，전간공제시간축단，진정분수제고（P<0.05）。결론병박분급미체서륜2자연합항전간적료효우우단독사용。
Objective To evaluate the efficacy and side-effect of propofol and midazolam and combined treatments of refractory status epilepticus.Methods 75 patients with refractory status epilepticus from 2013, January to 2014, January were randomly divided into the propofol group (n=25), midazolam group (n=25) and combined treatment group (n=25). HR, RR, SBP, DBP, SpO2, Ramsay evaluation, the time of effects and side-effect were recorded before drugs were used, after the refractory status epilepticus was controlled and treatment was stoped.Results The overall combined treatment group was 92.0% effective, significantly higher than propofol and midazolam group, 80.0% and 84.0% (P<0.05). There was significant difference in HR, RR, SBP, DBP, SpO2 in three groups before using drugs and after that(P<0.05). Combined treatment can reduce the drug amounts, the time to work on and increase the value of Ramsay evaluation(P<0.05).Conclusion The combined treatment has a better efficacy than using propofol and midazolam respectively.