咪达唑仑滴鼻和水合氯醛灌肠治疗儿童急性惊厥的对照研究

Comparing the treatment effect of MDL nasal delivery solution and MCH enema on acute convulsion of children

目的:比较咪达唑仑(MDL)溶液鼻腔给药与水合氯醛(Mit.Chloral Hydrate,MCH)溶液灌肠治疗小儿急性惊厥的疗效,探讨小儿急性惊厥安全方便而又高效的治疗方法。方法:将88例急性惊厥患儿随机分为MDL组(44例)和MCH组(44例)两组,分别采用鼻腔内滴入咪达唑仑溶液(0.15～0.45 mg/kg)和灌肠MCH溶液(每次250 mg/kg,极量每次为1 g/kg)的方法来治疗小儿急性惊厥。对出现反复惊厥或惊厥持续状态的患儿,前组MDL维持0.5～3.0 mg/(kg.h)治疗,后组MCH(每次500 mg/kg)治疗,或联合氯硝西泮(0.05～0.10)mg/kg静脉推注治疗,比较两种方法的疗效。结果:所有患儿均于10 min内均得到基本控制,MDL组和MCH组平均控制时间差异无显著性。MDL在10 min和15 min后有7例和3例的控制时间分别为(35±25)min和(55±18)min;MCH在10 min和15 min后15例和6例控制时间分别为(58±32)min和(83±24)min。MDL发作控制时间较MCH明显缩短,两组差异有统计学意义(P<0.05)。两组没有出现副反应。结论:咪达唑仑(MDL)溶液鼻腔给药治疗小儿急性惊厥疗效优于水合氯醛(MCH)灌肠,起效更快,稳定性较好。两组抗小儿急性惊厥均具有起效快速、疗效可靠、使用方便、操作简单、安全性高等优点。

Objective：To compare the treatment effect of MDL nasal delivery solution and MCH enema on acute convulsion of children for a safe,convenient and effective solution for the disease.Methodology：Firstly,divided 88 children with acute convulsion into MDL group（44 children）and MCH group（44 children）.Used MDL nasal delivery solution 0.15-0.45 mg/kg for children in MDL group and MCH enema（each time 250 mg/kg,or 1 g/kg at most for particular time）.Secondly,for children with repetitive or status convulsion after first stage treatment,increased the dosages to 0.5-3.0 mg/（kg·h） for remained MDL group cases and 500 mg/kg per time for remained MCH group cases respectively,or adding CZP intravenous push 0.05-0.10 mg/kg.Lastly,compared the treatment effect of the two solutions.Results：Symptoms of all the children were basically under control in 10 minutes after treatment.Data showed no differences in average times between the MDL and MCH solutions in stopping the symptoms in the first 10 minutes after treatment.In MDL group,there were 7 and 3 cases under control after 10 minutes and 15 minutes respectively,with（35±25） and（55±18） minutes used;In MCH group,there were 15 and 6 cases under control after 10minutes and 15minutes respectively,with（58±32） and（83±24） minutes used.These showed MDL solution was obviously faster than MCH solution in controlling such cases.Statistics showed P0.05,there were differences in effects of the two solutions.Both the two solutions did not cause side effect.Conclusion：MDL nasal delivery solution has faster and more stable treatment effect than MCH enema on acute convulsion of children.However,the two solutions both show fast,reliable,safe treatment effect on acute convulsion of children,with an easy and simple operation.