咪达唑仑对成人癫痫持续状态的疗效观察  

Study on the efficacy of midazolam treating status epilepticus in adults

作　　者：林天来[1] 丁志荣[1] 魏思灿[1] 于凯[1] 

机构地区：[1]福建医科大学附属泉州第一医院ICU,362000

出　　处：《中国临床实用医学》2010年第1期63-64,共2页China Clinical Practical Medicine

摘　　要：目的探讨咪达唑仑静脉持续输注治疗成人癫痫持续状态的疗效。方法选择23例成人癫痫持续状态作为研究对象，先予咪达唑仑0．1mg／kg静脉注射后予0．1mg／（kg·h）静脉持续输注，如癫痫再发作，加用咪达唑仑0．1mg／kg静脉注射并以0．05mg／（kg·h）幅度加量，直到惊厥控制，如果给药剂量达0．6mg／（kg．b）时，癫痫未控制考虑无效，不再加大用药剂量。如持续24h无癫痫发作，予逐渐减量，每12h以0．05～0．1mg／（kg·h）减量直至停用。所有患者同时胃肠道给予其他1至3种抗癫痫药物，并积极治疗原发病和并发症等处理。结果13例显效，7例有效，3例无效，总有效率为86．96％，3例出现低血压，经小剂量多巴胺升压及适当补液后纠正；2例出现呼吸减慢，血氧饱和度尚维持90％以上，未予特殊处理。结论静脉持续输注咪达唑仑是治疗癫痫持续状态的安全有效方法，值得推广。Objective To observe the efficacy of midazolam given as a continuous infusion in the treatment of status epilepticus （SE）in adults. Methods Twenty-three adults with SE received a bolus of midazolam 0. 1 mg/kg intravenously,followed by a continuous infusion of 0. 1 mg/（ kg ·h）. When the episode of seizures continued, a second bolus of midazolam 0. 1 mg/kg was given intravenously, and the dose in continuous infusion was increased by 0. 05 mg/（ kg ·h） until the seizures were brought under control. When the totoal amount of dose reached 0. 6 mg/（ kg · h）and the episode continued, it was reckoned ineffective and no more dose was given. When the episode disappeared for 24 hours, the dose was decresed by 0.05 - 0. 1 mg/（ kg · h） every 12 hours until it ends. Meanwhile, all patients were given one to three kinds of anti-epileptic and the primary affection and related syndrome was treated accordingly. Results The midazolam worked effectively in 13 patients, and had effect on7 patients;no effect was in 3 patients. The efficacy rate came to 86. 96%. Three of the patients got a low blood pressure and recoverd after given a small dose of dopamine and relevant fluid infusion ; the respiration rate of two patients slowed and was not given treatment for their oxygen saturation remained above 90%. Conclusion Midazolam is an effective and safe drug to control refractory seizures in adults with SE.

关 键 词：咪达唑仑 癫痫持续状态 治疗 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R971.2[医药卫生—临床医学]