咪达唑仑治疗儿童癫痫持续状态及惊厥频繁发作的临床研究

目的研究咪达唑仑持续静脉滴注治疗癫痫持续状态SE,包括难治性癫痫(R SE)]及频繁惊厥发作(FCS)的临床疗效,同时探讨其安全有效剂量及副作用。方法选取收入院的SE及FCS患儿205例为观察对象,随机分为两组,治疗组103例,给予咪达唑仑持续静脉滴注;对照组102例,应用传统的一线抗癫痫药(AED s)治疗。同时将两组疗效进行对照研究,观察治疗组的最大、最小用药剂量,副反应,51例患儿进行脑电图监测。结果治疗组疗效明显高于对照组(P<0.01),治疗组的咪达唑仑安全有效剂量为1￣8μg.kg-1.m in-1,在治疗剂量下未见明显副作用,37例痫样放电随着临床发作的终止消失,14例随着发作次数的减少而减少。结论持续静脉滴注咪达唑仑治疗SE及FCS安全、可靠、有效,且常规一线AEDs治疗无效后该药仍有效,故该药可推荐为治疗癫痫持续状态及频繁惊厥发作的最佳选择。

Treatment of midazolam to continuous status epilepticus and frequent convulsion seizures

Objective To study the curative effect of midazolam to continuous status epilepticus (SE,includ-ing refractory status epilepticus,RSE) and frequent convulsion seizures (FCS) when it′s continuously given as a drip infusion,as well as to investigate its safe and effective dosage and adverse reaction.Methods Study comprised 205 children with SE or FCS,they were divided randomly into 2 groups:To 103,midazolam was continuously given as a drip infusion,as a contol;102 were given the first-line anti-epilepsy drugs(AEDs). Then their curative effects were compared,and the maximum and minimum safe dosages and side effects of midazolam were checked;51 cases underwent the EEG recording.Results Midazolam was more effective than the first-line AEDs;its safe dosage was 1~8 μg·kg-1·min-1,no side effects were found.Thirty-seven cases had their epileptic discharge disappear along with the seizure ending,14 cases reduced their discharge with the decrease of seizures.Conclusion Continuously administering midazolam is safe and effective to SE (including RSE) and FCS when the first-line AEDs are ineffective. So midazolam should be first chosen when continuous status epilepticus exists or convulsion seizures frequently occur.