小剂量丙戊酸钠和小剂量安定防治小儿热性惊厥的疗效及安全性比较  

Comparison on the efficacy and safety of low-dose sodium valproate and Valium in the prevention and treatment of febrile seizures in children

作　　者：卢仕仰 饶福光 刘巧红[1] 

机构地区：[1]深圳市龙岗区妇幼保健院,518172

出　　处：《中国现代药物应用》2017年第20期93-95,共3页Chinese Journal of Modern Drug Application

摘　　要：目的比较小剂量丙戊酸钠(VPA)和小剂量地西泮(商品名:安定)防治小儿热性惊厥(FS)的疗效及安全性。方法 92例FS反复发作患儿为研究对象,采用随机数字表法分为安定组和VPA组,各46例。两组均给予常规抗感染、解热、氧疗等对症处理措施,VPA组给予小剂量VPA治疗,安定组给予小剂量安定治疗。两组均给予6个月随访,比较治疗前与治疗后6个月时Gesell发育量表(GDS)评分、退热时间、止痉时间、服药期间不良反应及随访6个月期间FS复发情况。结果治疗前,两组GDS评分比较,差异无统计学意义(P>0.05);治疗后6个月,两组GDS评分均较本组治疗前升高,且安定组升高程度优于VPA组,差异均具有统计学意义(P<0.05)。安定组退热时间为(36.13±2.17)h、止痉时间为(0.93±0.12)h,均短于VPA组的(38.37±3.39)、(1.21±0.16)h,差异均具有统计学意义(P<0.05)。服药期间,安定组转氨酶升高发生率为0,低于VPA组的8.70%,差异具有统计学意义(P<0.05);两组嗜睡、易激惹、乏力发生率比较,差异无统计学意义(P>0.05)。安定组FS复发率与VPA组比较,差异无统计学意义(χ2=3.823,P=0.505>0.05)。结论小剂量安定用于防治小儿FS的效果较小剂量VPA好,可加快患儿症状进程,且安全性较高,利于提高FS患儿认知发育水平,对患儿病情转归有积极意义。Objective To compare the efficacy and safety of low-dose sodium valproate and diazepam（trade name： Valium） in the prevention and treatment of febrile seizures（FS） in children. Methods A total of 92 FS recurrent attacks children as study subjects were divided by random number table method into Valium group and VPA group, with 46 cases in each group. Both groups received symptomatic treatment measures of routine anti-infection, antipyretic and oxygen therapy, and VPA group was also treated with low-dose VPA. Valium group was also treated with low-dose Valium. After 6 months of follow-up, comparison were made on Gesell development scale（GDS） score before treatment and 6 months after treatment, defervesce time, antispasmodic time, adverse events during the treatment and the recurrence of FS at 6 months follow-up. Results Before treatment, both groups had no statistically significant difference in GDS score（P〉0.05）. After 6 months of treatment, both groups had higher GDS score than before treatment, and Valium group had higher score than VPA group. Their difference was statistically significant（P〈0.05）. Valium group had defervesce time as（36.13±2.17） h, antispasmodic time as（0.93±0.12） h, which were all shorter than（38.37±3.39） and（1.21±0.16） h in VPA group, and the difference was statistically significant（P〈0.05）. During medication, Valium group had lower incidence of elevated transaminase as 0 than 8.70% in VPA group, and the difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in incidence of lethargy, irritability, fatigue（P〉0.05）. Valium group had no statistically significant difference in FS recurrence rate comparing with VPA group（χ^2=3.823, P=0.5050.05）. Conclusion Low-dose Valium shows better effect in prevention and treatment of FS in in children than low-dose VPA, and can speed up the progress of symptoms in children and with higher security, along with improving the cognitive developmen

关 键 词：丙戊酸钠 热性惊厥 地西泮 小剂量 安全性 

分 类 号：R720.597[医药卫生—急诊医学]