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托吡酯治疗伴有脑结构严重异常的儿童癫痫疗效观察 |
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［摘要］ 目的 观察托吡酯对有严重脑结构损害的儿童癫痫的疗效。方法 回顾性分析我院神经内科门诊就诊的伴有明显影像学异常的62例患者的临床资料。结果 本组病例托吡酯平均维持量6.3 mg/（kg·d）。应用托吡酯单药/添加治疗中，发作减少75%以上达67.7%，完全控制无发作（>6个月）达41.9%。在完全控制无发作患儿中，单药治疗组明显高于添加治疗组（P＜0.01）。11.3%的患者随着发作控制精神运动及智力水平有明显进步,仅1.6%患者因不良反应而退出。结论 随着经验的积累，新型抗癫痫药托吡酯在伴有影像学严重异常的儿童癫痫患者治疗中，有较高的有效控制率,治疗中强调个体化调整。
［关键词］ 癫痫；结构异常，脑；托吡酯；儿童
Analysis of therapeutic efficacy of topiramate in children with epilepsy and severe brain structure abnormality
YU Xiao-li,Ye Lu-mei.
Tianjin Children Hospital,Tianjin 300074,China
［Abstract］ Objective To observe the therapeutic efficacy of topiramate（TPM） in children epilepsy with severe brain structure abnormality. Methods Sixty-two children with epilepsy and severe brain structure abnormality were evaluated retrospectively, and were divided into groups of monotherapy and add-on therapy to make a compared analysis. Results The average maintenance dose of TPM in all children was 6.3 mg/（kg·d）. The rate of seizure decrease >75% in all children was 67.7%, and the rate of seizure complete control was 41.9%. In children of seizure complete control, the complete control power of monotherapy group was higher than that of add-on therapy group. In add-on therapy group,13.8%children cannot be effective control.About 11.3% children had visible improvement in psychomotor and intelligence, and only 1.6% children exited the observation for adverse effect. Conclusion TPM had high effective control power in children with epilepsy and severe brain structure abnormality. Individuation,long-term therapy were emphasized, neurosurgery ought to be considered in specified situations.
［Key words］ epilepsy;structural abnomalities,brain；topiramate;children
临床上，伴有影像学异常的儿童癫痫多考虑为继发性癫痫。虽然癫痫的诊断不需要影像学证据，但有严重脑结构损害的癫痫患者常常症状严重，且癫痫长期反复发作又会加重患者的病情及脑功能损害。，新型抗癫痫药托吡酯（topiramate,TPM）在癫痫部分性发作中的明显疗效及突出的安全性已被国内外认同。除添加治疗外，还可[1] [2] [3] [4] 下一页
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