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[新生儿惊厥的治疗]

[Treatment of neonatal convulsions].

作者信息

Zimmermann B, Gouyon J B

机构信息

Service de pédiatrie 2, hôpital d'enfants, Dijon, France.

出版信息

Arch Pediatr. 1997 Sep;4(9):875-82. doi: 10.1016/s0929-693x(97)88159-6.

Abstract

Three important measures are concommitantly recommended in the treatment of neonatal seizures. 1) The maintenance of vital functions by supplying oxygen and using mask ventilation in addition to cardiac monitoring and placing an intravenous line. 2) The search for an etiology through metabolic and infectious laboratory tests. In many cases this will lead to an etiological treatment. 3) The specific treatment of the seizures: intravenous or intrarectal diazepam is the first line treatment. Phenobarbital, then phenytoin and clonazepam are used when diazepam is unsuccessful. Indications and duration of a secondary prophylactic treatment are controversial and must be discussed on the basis of the electroencephalographic data and the risk factors for epileptic seizures during the neonatal period and at 3 months of age.

摘要

在新生儿惊厥的治疗中,同时推荐采取三项重要措施。1)通过供氧、使用面罩通气,以及进行心脏监测和建立静脉通路来维持生命功能。2)通过代谢和感染方面的实验室检查寻找病因。在许多情况下,这将导向病因治疗。3)惊厥的特异性治疗:静脉注射或直肠给予地西泮是一线治疗方法。地西泮治疗无效时,使用苯巴比妥,然后是苯妥英钠和氯硝西泮。二级预防性治疗的指征和持续时间存在争议,必须根据脑电图数据以及新生儿期和3个月大时癫痫发作的危险因素进行讨论。

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