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咪达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].

作者信息

Tang Rong-Hua, Zhou Jiang-Bao

机构信息

Department of Pediatrics, Suining Central Hospital, Suining, Sichuan 629000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2010 Jul;12(7):530-2.

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.

摘要

目的

比较咪达唑仑和地西泮治疗儿童急性惊厥的疗效。

方法

120例急性惊厥患儿随机分为两组:咪达唑仑组(0.1 - 0.3mg/kg)和地西泮组(0.3 - 0.5mg/kg),每组60例。对于惊厥复发或惊厥持续状态的患儿,咪达唑仑组给予咪达唑仑维持剂量(1 - 8mg/kg每小时),地西泮组给予地西泮维持剂量(0.5 - 1mg/kg每小时)或联合苯巴比妥钠。比较两组的治疗效果。

结果

咪达唑仑或地西泮给药10分钟后,两组所有患儿的惊厥均得到缓解。两组惊厥控制的平均时间无显著差异。咪达唑仑组有5例患儿在10分钟后惊厥复发或出现惊厥持续状态,地西泮组有13例(P<0.05)。维持治疗后,咪达唑仑组惊厥控制时间平均为40±32分钟,地西泮组为69±24分钟(P<0.05)。未观察到与咪达唑仑和地西泮治疗相关的不良事件。

结论

咪达唑仑治疗儿童急性惊厥安全有效。在治疗复发性惊厥或惊厥持续状态方面,咪达唑仑似乎比地西泮是更好的选择。

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