氯硝安定与安定溶液直肠给药用于惊厥急救的对照研究

A comparative study on the efficacy of clonazepam and diazepam solution administered rectally in seizure control in children

目的以安定为对照，探讨氯硝安定溶液直肠给药对惊厥急救的实用价值。方法在２８例儿童中对比观察直肠注入氯硝安定与安定溶液的吸收速度和对脑电活动的影响，并比较两药对大鼠实验性惊厥的疗效。结果氯硝安定与安定溶液均能从直肠迅速吸收，皆于用药５分钟后达有效血浓度，分别于３～８分钟及２～８分钟对脑电活动产生显著影响，明显抑制癫痫样波发放，使美解眠诱发的惊厥致死率从对照组的７０％降为０。结论氯硝安定与安定溶液直肠给药，均能作为小儿惊厥抢救的有效措施。

Objective To explore the clinical value of rectal administration of clonazepam (CZP) solution for seizure control in children. Methods CZP (0.1 mg/kg) or diazepam (DZP, 0.5 mg/kg) solution was administered rectally to 28 children; their absorptive rates and the effects on epileptic discharges on EEG recording were observed and their effects on experimental seizures of rats induced by megimide were compared.Results CZP was absorbed from rectum as rapidly as DZP was in children. At 3 8 min, 2 8 min after CZP or DZP administration, EEG patterns significantly changed with disappearance of most epileptic discharges. The experimental seizures incidences in rats declined from 100% in control group to 50% in CZP and 80% in DZP group. No death occured in both experimental groups but 70% in control group.Conclusion Both CZP and DZP solutions administered rectally were safe, quick and effective for seizure control, which can be used easily and conveniently in clinical practice.