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目的:探讨频发外伤性癫痫的发病机制以及在重症医学科的治疗方法。方法:回顾性分析我院神经外科自2008年2月～2012年8月在重症医学科16例外伤后频发癫痫后的治疗临床资料。结果:所有外伤性频发癫痫病例,采用气管插管呼吸机辅助呼吸,镇静适当的肌松,静脉控制性滴注丙戊酸钠,持续治疗3～7天,频发癫痫均得到有效控制,后期口服抗癫痫药即可。结论:对于外伤性频发癫痫患者,血性脑脊液刺激、血肿压迫、骨折片刺入、白质灰质挫裂伤,手术打击等均会导致脑水肿及出现癫痫灶。通过在重症医学科的监护和上述方法治疗,可使患者平稳度过脑水肿高峰期,避免频发癫痫加重脑水肿从而导致癫痫的恶变,也为丙戊酸钠抗癫痫治疗提供最佳时机。
Objective: To investigate the pathogenesis of frequent traumatic epilepsy and the treatment of severe medical subjects. Methods: A retrospective analysis of our hospital neurosurgery from February 2008 to August 2012 in the Department of Critical Care Medicine 16 cases of traumatic post-traumatic epilepsy after treatment of clinical data. Results: All traumatic cases of epilepsy, the use of endotracheal intubation ventilator-assisted breathing, calm the appropriate muscle relaxant, intravenous infusion of sodium valproate, continuous treatment of 3 to 7 days, frequent epilepsy are effectively controlled, Late oral antiepileptic drugs can be. Conclusion: For patients with traumatic epilepsy, bloody cerebrospinal fluid stimulation, hematoma compression, bone fracture penetration, white matter gray matter contusion and laceration, surgical strike and so on will lead to cerebral edema and epileptic foci. Through intensive care in intensive care and treatment with the above methods, patients can be smoothly over the peak period of cerebral edema, to avoid frequent epilepsy increased cerebral edema resulting in malignant epilepsy, but also for valproate antiepileptic treatment provide the best time.