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目的 评价抗癫痫药单药大剂量及联合用药治疗小儿难治性癫痫的疗效。方法 在血药浓度监测下对 5 4例患儿投予大剂量卡马西平 (CBZ)或丙戊酸钠 (VPA) ,无效者及呈混合类型发作者采取联合用药方式。结果 单用CBZ者 11%发作获完全控制 ,单用VPA者 15 %发作停止。这些患儿的血药浓度均已达到或超过有效浓度的上限。全组单药或联合用药共 17例 (2 7% )患儿获控制 ,16例 (2 6 % )发作减少 5 0 %以上。结论 难治性癫痫患儿可以采用单药大剂量治疗及联合用药的方法 ,但应注意监测血药浓度 ,以避免发生中毒反应
Objective To evaluate the efficacy of antiepileptic drug monotherapy in combination with high-dose monotherapy in the treatment of refractory epilepsy in children. Methods Fifty-four children were given high-dose carbamazepine (CBZ) or sodium valproate (VPA) under the monitoring of plasma concentration, and the combination therapy was used in those who were ineffective and those with mixed type. Results CBZ alone 11% of attacks were completely controlled, 15% of patients with VPA alone stopped. The plasma concentrations of these children have reached or exceeded the upper limit of effective concentration. Seventeen (27%) children in the group were controlled and 16 (26%) had a 50% reduction in their seizures. Conclusion Children with refractory epilepsy can adopt single-agent high-dose therapy and combination therapy, but should pay attention to monitoring blood concentration to avoid toxic reactions