鼻腔滴入咪达唑仑治疗儿童急性惊厥的疗效观察  

Clinical effectiveness of intranasal midazolam administration in acute children seizures control

作　　者：朱近[1] 张玉琴[1] 张培元[1] 李鸿[1] 刘晓军[1] 

机构地区：[1]天津市儿童医院神经内科,天津300074

出　　处：《中国实用儿科杂志》2009年第4期300-301,共2页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨咪达唑仑鼻腔给药治疗儿童急性惊厥的疗效及安全性。方法2004年12月至2006年12月将天津市儿童医院收治的93例急性惊厥患儿随机分为治疗组49例和对照组44例,治疗组鼻腔滴入咪达唑仑0.16～0.32mg/kg,平均(0.24±0.05)mg/kg;对照组静脉推注氯硝西泮0.04～0.10mg/kg,平均(0.077±0.021)mg/kg。观察两组疗效及安全性。结果治疗组43例有效,有效率87.76%;对照组39例有效,有效率88.64%。两组比较差异无统计学意义(P>0.05)。治疗组惊厥控制时间为1～7min,平均(2.13±1.30)min;对照组惊厥控制时间为1～5min,平均(1.96±1.08)min,两组比较,差异无统计学意义(P>0.05)。治疗组与对照组在全面性发作及局灶泛化全面性发作两种不同类型发作的治疗方面,有效率及惊厥控制时间比较差异无统计学意义(P>0.05)。治疗组未发现明显副反应,对照组1例患儿在用药30min后出现呼吸抑制。结论咪达唑仑鼻腔给药可有效控制儿童急性惊厥,与静脉推注氯硝西泮疗效相当,且更安全方便。Objective A total of To study the effectiveness and security of intranasal midazolam for acute seizures in children. Methods 93 cases were randomly divided into two groups, observation group of 49 cases and control group of 44 cases. In observation group, 0.16- 0.32 （0.24±0.05）mg/kg midazolam was supplied in nasal drip. In control group, 0.04 - 0.10（0.077±0.021 ）mg/kg clonazepam was injected intravenously. Results It was effective in observation group and the efficacy rate was 87.76%, while it was effective in 39 cases in control group and the efficacy rate was 88.64%. There was no significant difference between two groups（P 〉 0.05 ）.In observation and control group, the effectiveness occurred at 1 -7 （2.13 ± 1.30） min and 1 - 5 （1.96 ± 1.08 ）min later separately. There was no significant difference between two groups（P 〉 0.05）. The efficacy and the control time of tic in generalized and secondarily generalized seizures of the groups bad no significant difference between two groups（P 〉 0.05）. There was no side effect in observation group. After 30 minutes of administration, one child had respiratory resistance in control group. Conclusion The curative effect of intranasal midazolam and intravenous clonazepam was equivalent in acute seizure control. Intranasal midazolam is more convenient and safer.

关 键 词：咪达唑仑 儿童 惊厥 西洋 氯硝西泮 

分 类 号：R72[医药卫生—儿科]