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目的 探讨丙戊酸快速静脉给药治疗 2岁以下婴幼儿频繁癫疒间 发作的疗效及安全性。方法 对 2 0例频繁癫疒间发作的 2岁以下婴幼儿 ,应用丙戊酸负荷量 (2 0mg/kg ,5min静脉推入 ,静注速度为 2 4～ 6 0mg/min) ,维持量 [5mg/ (kg·h)用 5h],巩固量 [1mg/ (kg·h)用 5～ 10h],进行快速静脉给药治疗 ,用药前后监测患儿生命体征、肝功能、丙戊酸血浓度及血氨 ,综合判定疗效及安全性。结果 治疗有效率 85 % ,给药期间生命体征基本平稳 ,个别患儿负荷量后出现心率增快、血压上升 ;肝功能、血氨均在正常范围 ;丙戊酸血浓度波动在每毫升 (97 8±2 8)～ (10 1 5± 2 5 ) μg之间。 结论 应用所制定的丙戊酸负荷量 维持量 巩固量快速静脉给药法可以较为安全有效地控制 2岁以下婴幼儿的频繁癫疒间发作。
Objective To investigate the efficacy and safety of rapid intravenous valproate in the treatment of frequent epileptic seizures in infants under 2 years of age. Methods Twenty patients under 2 years of age who had frequent epileptic seizures were treated with valproic acid loading (20 mg / kg, 5 min intravenously and intravenous infusion at 24 to 60 mg / min) 5mg / (kg · h) with 5h], the amount of consolidation [1mg / (kg · h) with 5 ~ 10h] for rapid intravenous administration before and after treatment monitoring of vital signs, liver function, valproic acid blood concentration And blood ammonia, a comprehensive evaluation of efficacy and safety. Results The effective rate of treatment was 85%. The vital signs were basically stable during the administration. The heart rate increased and the blood pressure increased after the load of some children. The liver function and blood ammonia were in the normal range. The plasma concentration of valproic acid fluctuated at a rate of 97 8 ± 2 8) ~ (10 1 5 ± 2 5) μg. Conclusion The application of the valproic acid load to maintain the amount of solidification rapid intravenous administration method can be more safely and effectively control infants and children under 2 years of frequent epileptic seizures.