目的 觀察奧氮平聯(lián)合丙戊酸鈉治療難治性癲癇持續(xù)狀態(tài)的臨床效果。方法 采用回顧性、隨機對照研究方法，將2015年2月—2017年9月在遂寧市中心醫(yī)院診治的難治性癲癇持續(xù)狀態(tài)患者190例分為觀察組與對照組各95例，對照組給予丙戊酸鈉治療，初劑量為5~10 mg/（kg·d），然后每周增加劑量5~10 mg/（kg·d），持續(xù)增加到劑量為20~30 mg/（kg·d）后進行維持治療。觀察組在對照組治療的基礎上給予奧氮平6 mg治療，1次/d。兩組都治療觀察4周。比較兩組近期療效、不良反應及認知功能情況。結(jié)果 觀察組與對照組的總有效率分別為98.9%和88.4%，觀察組明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組的不良反應發(fā)生率4.2%與對照組（6.3%）無統(tǒng)計學差異。兩組治療后的簡易精神狀態(tài)檢查量表（MMSE）評分均明顯高于治療前，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且觀察組的MMSE評分明顯高于對照組，組間差異有統(tǒng)計學意義（P<0.05）。結(jié)論 奧氮平聯(lián)合丙戊酸鈉治療難治性癲癇持續(xù)狀態(tài)能提高治療效果，不會增加不良反應的發(fā)生，能促進患者認知功能的改善，有很好的應用效果。

Objective To observe the clinical effects of olanzapine combined with valproate in the treatment of refractory status epilepticus. Methods Use a retrospective, randomized study method, From February 2015 to September 2017, 190 patients of intractable epilepsy with persistent state in our hospital diagnosis and treatment were selected as the research object and were divided into study group and control group with 95 patients in each group accorded to the different treatment methods. The control group was given sodium valproate treatment, the study group was given olanzapine treatment based on the control group treatment, two groups were treated for four weeks.Results The total effective rates in the study group and the control group were 98.9% and 88.4% respectively, and the study group was significantly higher than the control group (P<0.05). The incidence of adverse reactions in the study group was 4.2 percent (4/95) and the control group was 6.3% (6/95) with no statistical difference. MMSE scores of both groups were higher than those before treatment, and the MMSE score of the study group was higher than that in the control group (P<0.05). Conclusion Olanzapine combined with valproate in the treatment of refractory status epilepticus can improve the therapeutic effect, do not increase the occurrence of adverse reactions, and improve the cognitive function of patients. So it has a good application effects.