摘要
目的探讨奥氮平联合丙戊酸镁缓释片治疗尿毒症脑病所致精神障碍患者的疗效。方法选取2013年3月至2018年6月在湖南省第二人民医院住院的尿毒症脑病所致精神障碍(主要表现为幻觉、被害妄想、躁狂、异常兴奋等精神异常)患者93例,分为合用组(33例)、单用组(30例)及对照组(30例)。对照组患者采用血液净化(每周2次血液透析+1次血液透析滤过治疗)+对症支持治疗,单用组在对照组治疗基础上加用奥氮平,合用组在对照组治疗基础上加用奥氮平+丙戊酸镁缓释片,疗程均为2周。采用阴性及阳性量表(PANSS)评定患者的临床疗效,并以不良反应量表(TESS)评定不良反应。结果合用组治疗1周末、2周末时PANSS评分明显低于单用组及对照组,差异有统计学意义(P<0.05),同时单用组治疗2周末时PANSS评分明显低于对照组,差异有统计学意义(P<0.05);合用组患者精神症状控制更佳,疗效更显著。单用组与合用组TESS评分比较差异无统计学意义(P>0.05)。结论奥氮平联合丙戊酸镁缓释片治疗表现为精神障碍的尿毒症脑病患者显效更快,控制率更高,疗效好且安全,可快速控制患者精神症状,可在临床上推广使用。
Objective To explore the efficacy of olanzapine combined with magnesium valproate sustained release tablets in the treatment of patients with mental disorders caused by uremic encephalopathy. Methods Ninety-three patients with mental disorders caused by uremia encephalopathy(mainly manifested as hallucinations, paranoia, mania, abnormal excitement, etc.), who were admitted to our hospital from March 2013 to June 2018, were selected and divided into three groups: combined group(33 cases), single-use group(30 cases) and control group(30 cases). Patients in the combined group were treated with olanzapine combined with magnesium valproate sustained release tablets plus blood purification(hemodialysis twice + hemodiafiltration once per week) and symptomatic supportive treatment. Patients in the single-use group were treated with olanzapine plus blood purification(hemodialysis once + hemodiafiltration once per week) and symptomatic supportive treatment. Patients in the control group only received blood purification(hemodialysis twice + hemodiafiltration once per week) and symptomatic support treatment. The course of treatment is 2 weeks for all the groups. The clinical efficacy of the patients was assessed by the negative and positive scale(PANSS), and adverse reactions were observed in both the groups. Adverse reactions were assessed by the treatment emergent symptom scale(TESS). Results The PANSS scores in the combined group were significantly lower than those in the single-use group and the control group at weekends 1 and 2 of the treatment course, with difference of statistically significance(P<0.05). And the PANSS scores in the single-use group was significantly lower than in the control group at weekend 2, with difference of statistical significance(P<0.05). The patients in the combined group had better control of mental symptoms and the curative effect was more significant. There was no significant difference in TESS score between the two groups(P>0.05). Conclusions Olanzapine combined with magnesium valproate sustained release tablets for the treatment of uremic encephalopathy patients with mental disorders has more rapid response, higher control rate, and good and safe efficacy, and so can quickly control the patient's mental symptoms. For uremic encephalopathy patients with mental disorders it can be promoted clinically.
引文
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