咪哒唑仑与地西泮治疗小儿急性惊厥的对照研究

A control study on the treatment of acute seizures with midazolam and diazepam in children

摘要:

目的：比较咪哒唑仑（MDL）与地西泮（DZP）治疗小儿急性惊厥的疗效，探讨小儿急性惊厥安全、高效的治疗方法。方法：将120例急性惊厥患儿随机分为MDL组(60例)和DZP组(60例),分别予MDL（0.3~0.5 mg/kg）和DZP(0.5~1 mg/kg)治疗，对出现惊厥反复或呈惊厥持续状态患儿，前组给予MDL维持（每小时1~8 mg/kg），后组给予DZP维持（每小时0.5~1 mg/kg）或联合苯巴比妥钠治疗，比较两种方法疗效。结果：全部患儿于10 min内惊厥得到基本控制，MDL组与DZP组平均控制时间差异无统计学意义。MDL组与DZP组分别有5例及13例患儿10 min后出现惊厥反复或呈惊厥持续状态。维持治疗后平均控制时间分别为40±32 min和69±24 min，差异有统计学意义 (P<0．05)。两组中无一例出现与MDL及DZP相关的副反应。结论：MDL用于治疗小儿急性惊厥安全、高效，对于惊厥反复或呈惊厥持续状态患儿，疗效优于DZP。［中国当代儿科杂志，2010，12（7）：530-532］

Abstract:

OBJECTIVE: To compare the efficacy of midazolam and diazepam for treatment of acute seizures in children. METHODS: One hundred and twenty children with acute seizures were randomly divided into two groups: midazolam (0.1-0.3 mg/kg) and diazepam treatment (0.3-0.5 mg/kg) (n=60 each). In cases with seizure recurrence or statural convulsivus, a maintenance dose of midazolam (1-8 mg/kg per hour) and a maintenance dose of diazepam (0.5-1 mg/kg per hour) or along with phenobarbital sodium were given in the midazolam and diazepam treatment groups, respectively. The therapeutic effects were compared between the two groups. RESULTS: The seizures were relieved in all cases from the two groups 10 minutes after administration of midazolam or diazepam. There were no significant differences in the average time of seizure control between the two groups. Five children in the midazolam group had seizure recurrence or statural convulsivus after 10 minutes compared with 13 children in the diazepan group (P<0.05). The time of seizure control averaged 40±32 minutes in the midazolam group compared with 69±24 minutes in the diazepam group after maintenance treatment (P<0.05). No midazolam and diazepam treatment related adverse events were observed. CONCLUSIONS: Midazolam is safe and effective in the treatment of acute seizures in children. Midazolam appears to be a better option in the treatment of recurrent seizures or statural convulsivus than diazepam.［Chin J Contemp Pediatr, 2010, 12 (7):530-532］