Clinical analysis of adverse drug reactions and rational drug use of sodium valproate
丙戊酸钠临床药物不良反应分析及合理用药研究

摘要

目的 分析研究丙戊酸钠临床药物不良反应发生情况，并对其合理用药方法进行探讨。方法 抽取2019年1月到2022年3月间在我院接受丙戊酸钠治疗并在治疗过程中发生不良反应的癫痫患者50例作为研究对象，回顾分析患者的基本资料、给药情况、不良反应发生时的血药浓度以及不良反应的主要表现、处理方法及结果。结果 不同年龄段的癫痫患者中，以≤10岁的患儿丙戊酸钠不良反应发生的构成比最高，为24.00%，不同年龄段不同性别的患者构成比比较无统计学意义。患者给药途径均为口服，给药日剂量在0.5-1g的患者构成比最高，为48.00%。单独用药患者47例，占比94.00%，但联合用药癫痫控制效果较单药效果更好。用药10-30d内出现不良反应的患者40例，占比80.00%，构成比显著高于其他时间的患者。不良反应发生时的血药浓度在50-100μg/mL的构成比最高，为68.00%，但严重不良反应构成比最高的是血药浓度＞100μg/mL的患者。不良反应涉及多组织结构，尤以神经系统和消化系统不良反应构成比最高，分别为34.00%和22.00%。除1例患者出现脱发未恢复外，其余49例均在给药剂量调整、治疗药物更换后不良反应消退、恢复良好。结论 丙戊酸钠用于癫痫疾病的治疗过程中，会有一定的不良反应发生风险，临床医护工作者要积极了解并掌握相关规律，并对患者的血药浓度进行积极监测，做好患者的合理用药工作，保证患者的用药安全性。

Abstract

Objective: To analyze the clinical adverse reactions of sodium valproate, and to discuss the rational drug use methods.
Methods A total of 50 epilepsy patients who received sodium valproate treatment in our hospital from January 2019 to March 2022 and had adverse reactions during the treatment were selected as the research subjects. The blood drug concentration at the time of the reaction and the main manifestations, treatment methods and results of adverse reactions.
Results Among the epilepsy patients of different age groups, the proportion of adverse reactions of sodium valproate was the highest in children less than 10 years old, which was 24.00%. The routes of administration of the patients were all oral, and the proportion of patients with a daily dose of 0.5-1 g was the highest, which was 48.00%. There were 47 patients with single medication, accounting for 94.00%, but the effect of combined medication on epilepsy control was better than that of single medication. There were 40 patients with adverse reactions within 10-30 days of medication, accounting for 80.00%, and the composition ratio was significantly higher than that of patients at other times. The composition ratio of the blood drug concentration at 50-100 μg/mL at the time of adverse reactions was the highest, which was 68.00%, but the highest composition ratio of serious adverse reactions was in patients with blood drug concentration >100 μg/mL. The adverse reactions involved multiple tissue structures, especially the nervous system and digestive system had the highest proportion of adverse reactions, accounting for 34.00% and 22.00%, respectively. Except for 1 patient who suffered from hair loss and did not recover, the other 49 patients all recovered well after the dose adjustment and treatment drug replacement.
Conclusion  s During the treatment of epilepsy with sodium valproate, there will be a certain risk of adverse reactions. Clinical medical workers should actively understand and master the relevant laws, and actively monitor the blood drug concentration of patients, and do a good job in the patient's health. Rational drug use work to ensure the safety of patients' drug use.