大剂量安定为主治疗新生儿破伤风57例临床分析

目的:总结大剂量安定为主的治疗方案对新生儿破伤风的效果。方法:1998年至2003年收治的57例新生儿予以大量安定为主的治疗,安定的用法为:每次0.5 mg/kg-1 mg/kg静脉注射,每(1 h～2 h)/次,每次注射时间不少于3 min。抽搐好转后予以每次0.5 mg/kg-1 mg/kg的安定鼻饲,每(2 h～4 h)/次,然后根据患儿抽搐控制情况逐渐减少鼻饲安定量及延长鼻饲时间直至停药。结果:57例患儿中安定最大用量为每天15 mg/kg,最小用量为每天8mg/kg,单次最大剂量为1.5 mg/kg。治愈31例(54.4％);好转12例(21.1％);无效5例,其中3例应用肌松剂联合机械通气后治愈,2例需加用鲁米那或亚冬眠;放弃9例。治疗期间仅1例因呼吸抑制需行气管插管。结论:大剂量安定治疗破伤风经济,安全有效、副作用小,值得临床应用。

Clinical Analysis of Neonatal Tetanus Treated Mainly with Large Dose Valium

Purpose To summarize the curative effect of the curative scheme which mainlys with large dose valium to tetanus infantum. Methods Neonates hospitalized from 1998 to 2003 were given the curative scheme which mainly with large dose valium. The usage of valium were as bellow: First, 0. 5 mg/kg - 1 mg/kg every 1 hours - 2 hours by intravenous injection slowly (at least 3 min every injection). And seccnd, 0. 5 mg/kg-1 mg/kg every 2 hours-4 hours by nasal feeding after convulsive seizure got better. At last, the dosage decreased and the interval prolonged as far as stop administering according to the state of the illness. Results The largest dosage of valium was 15 mg/kg/d ,the least 8mg/kg/d and the largest single dosage 1. 5mg/kg among all 57 cases, 31 cases were cured, 12 improved, and 5 inefficacy in which 3 cases were cured by combination of muscle relaxant and mechanical ventilation and the other 2 cases used luminal or wintermin in addition. Conclusion The curative scheme which mainly with large dose valium to neonatal tetanus is safe effective and economical with few side-effects.