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用硝西泮间歇性治疗热性惊厥。

Intermittent treatment of febrile convulsions with nitrazepam.

作者信息

Vanasse M, Masson P, Geoffroy G, Larbrisseau A, David P C

出版信息

Can J Neurol Sci. 1984 Aug;11(3):377-9. doi: 10.1017/s0317167100045741.

Abstract

Intermittent oral or rectal administration of diazepam for the prophylactic treatment of febrile convulsions has given results comparable to the continuous use of phenobarbital while limiting side effects and risks of toxicity. Since we believe that nitrazepam is a better anticonvulsant than diazepam, we performed a study to evaluate the effectiveness of this medication in the prophylactic treatment of febrile convulsions. Nitrazepam was given only when the children had fever and almost exclusively in children with a high risk of recurrence (less than 12 months of age at first convulsion; atypical convulsion; one or several previous convulsions). Thirty one children with a high risk of recurrence received nitrazepam. The rate of recurrence in this group was 19.3% after a follow-up of 16 months, compared to 45.8% in 24 children who also had a high risk of recurrence but in whom the parents refused the medication or gave it inadequately (p less than 0.05). Fifty one children with a low risk of recurrence also were evaluated and followed for at least 12 months (mean 15.4 months). Six were treated with nitrazepam, mostly because of parental anxiety, and none had a recurrence; of the 45 untreated children in this group, 6 (13.6%) had another convulsion. These results show the efficiency of nitrazepam in the prophylactic treatment of febrile convulsions.

摘要

间歇性口服或直肠给予地西泮用于热性惊厥的预防性治疗,其效果与持续使用苯巴比妥相当,同时可减少副作用和毒性风险。由于我们认为硝西泮是比地西泮更好的抗惊厥药,因此我们进行了一项研究,以评估该药物在热性惊厥预防性治疗中的有效性。仅在儿童发热时给予硝西泮,且几乎仅用于复发风险高的儿童(首次惊厥时年龄小于12个月;非典型惊厥;有一次或多次既往惊厥)。31名复发风险高的儿童接受了硝西泮治疗。随访16个月后,该组的复发率为19.3%,相比之下,24名复发风险同样高但父母拒绝用药或用药不当的儿童的复发率为45.8%(p<0.05)。51名复发风险低的儿童也接受了评估并随访至少12个月(平均15.4个月)。其中6名儿童接受了硝西泮治疗,主要是因为家长焦虑,且均未复发;该组45名未治疗的儿童中有6名(13.6%)再次惊厥。这些结果表明硝西泮在热性惊厥预防性治疗中有效。

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