癫痫样发作的低血糖患者的临床特点及治疗探讨

摘要

目的：分析癫痫样发作的低血糖患者的临床特点和治疗。方法选取癫痫样发作的低血糖患者50例，按有无糖尿病史分为有糖尿病史组和无糖尿病史组，各25例。对2组低血糖患者的临床特点和临床治疗效果（神志清醒时间、血糖恢复正常时间）等进行分析，所有患者在入院后先对患者的糖尿病史、血糖进行检测，然后采用葡萄糖和营养治疗。结果50例癫痫样发作患者，入院血糖均偏低，癫痫发作的形式多样，经脑电地形图检查，均呈现不同程度的异常。所有患者经过治疗之后，癫痫症状得到迅速的改善，癫痫发作终止，脑电地形图检查恢复正常，治疗效果较好。2组患者在3 h之内，神志清醒和血糖恢复的情况比较，差异有统计学意义（P＜0.05）。说明给予50%的葡萄糖静脉注射及5%的葡萄糖静脉输液，直到患者的血糖恢复稳定，这种癫痫样发作的低血糖治疗方法，在有无糖尿病低血糖患者的治疗中，针对无糖尿病史的患者有非常好的治疗效果。在6h之内，神志清醒和血糖恢复的患者人数2组分别为24、25、24、25例，差异无统计学意义。所有患者在神志清醒后，没有癫痫样抽搐再次的发作的情况，脑电地形图检查均恢复正常。结论低血糖昏迷患者可能伴随着癫痫发作的危险，针对突然抽搐、昏迷的患者，在入院治疗后对其糖尿病史、血糖进行检测，及早的对患者的病情做出正确的诊断，然后采取治疗。%Objective To study the clinical features and treatment of epilepsy patients with hypoglycemia.Methods 50 cases of epilepsy patients with hypoglycemia, as the object of this study,25 patients with a history of diabetes mellitus, 25 patients with no history of diabetes, which is divided into diabetes group and non diabetes group. The clinical features and the clinical therapeutic effect of two groups of hypoglycemia (conscious time, blood glucose recovery time) were analyzed, all the patients after admission were ifrst detected on blood glucose in patients with diabetes mellitus, history, and then the glucose and nutritional therapy.Results Of 50 cases of epilepsy patients, admission blood glucose is low, the seizure of diverse forms, the EEG showed varying degrees of abnormal. All of the patients after treatment, the symptoms of epilepsy improved quickly, seizure termination, EEG recovery better treatment effect. Within 3h, sane and glucose recovery of two groups of patients there is a big difference (P<0.05), with statistical signiifcance. With 50% glucose intravenous injection and 5% glucose intravenous infusion, until blood glucose to restore stability, hypoglycemia treatment method of the epileptic seizures, with or without treatment in patients with diabetic hypoglycemia, with no history of diabetes patients have a very good therapeutic effect. Within 6h, the number of patients with conscious and glucose recovery of the two groups were 24, 25, 24, 25, no signiifcant differences, no statistical signiifcance. All patients in the sane,no epileptic convulsions again seizure, EEG were normal. Conclusion Because of hypoglycemic coma patients may be associated with the risk of seizures,the sudden convulsions, coma patients, the history of diabetes, blood glucose was detected after treatment in hospital, early detection of patients to make the correct diagnosis and treatment.