咪达唑仑持续静脉泵入治疗儿童癫(癎)持续状态的疗效观察

目的 观察咪达唑仑治疗儿童癫(癎)持续状态的疗效及不良反应.方法 将癫(癎)持续状态患儿按随机分配原则分为2组:研究组给予咪达唑仑0.3 mg/kg静注,15 min后若发作未能控制,以1～2 μg/(kg·min)持续静脉泵入,每15min增加1 μg/(kg·min),最大量20 μg/(kg·min).对照组给予安定0.3mg/kg静注,15 min后若发作未能控制,以5 μg(kg·min)持续静脉泵入.每15分钟增加.5 μg/(kg·min),最大量50 μg/(kg·min).结果 咪达唑仑组7例癫(癎)发作完全控制,1例在药量达20 μg/(kg·min)癫(癎)发作仍未控制,本组患儿控制癎痴持续状态的有效率为87.5%.安定组6例癫(癎)发作完全控制,1例在药量达50 μg/(kg·min)癫(癎)发作未控制,本组患儿控制癫(癎)持续状态的有效率为83.3%.两组控制惊厥疗效及控制惊厥药物起效时间的比较无显著性.安定组1例肌张力减低和1例呼吸抑制.咪达唑仑组未发现血压、心率、血氧饱和度和呼吸状态的变化.结论 咪达唑仑治疗癫(癎)持续状态起效快,效果好,不良反应小,可用于治疗癫(癎)持续状态.

Therapentic effects of midazolam on continuous status epileptics

Objective To compare the efficacy of continuous midazolam and diazepam infusion for the control of continuous status epileptics (CSE), and to investigate each safe dosage and serious side effect. Meth-otis Forteen children, 0.2 to 12 years of age, with CASE were divided into two groups: in midazolam group (n = 8), seizures uncontrolled after one doses of 0.3 mg/kg of midazolam, continuous midazolam in incremen-tal doses given as a drip infusion was administered; in diazepam group (n = 6), seizures uncontrolled after one doses of 0.3 mg/kg of diasepam, continuous diazepam in incremental doses given as a drip infusion was admin-istered, then comparing the therapeutic effects, and the safe dosages and side effects of midazolam and diazepam were checked. Results Continuous midazolam and diazepam infusions were equally effective for control of re-fractory status epilepticus. There was no significant difference in the proportion of children in two groups with successful control of CSE (P>0.05). However, midazolam was less serious side effect than diazepam. Respira-tory depression was found in one diazepam case. Conclusion Midazolam is effective and safe, and can be used as the first line durg in the treatment of status epilepticus in children.