咪达唑仑治疗酒精所致震颤谵妄效果分析

Efficacy of midazolam in treating delirium tremens

目的:探讨咪达唑仑对酒精所致震颤谵妄患者的疗效及安全性。方法:65例震颤谵妄患者随机分为2组,分别给予咪达唑仑及地西泮以微泵或直接静脉推注治疗。采用自制调查表及酒精戒断状态评定量表(CIWA-Ar)评定疗效,副反应量表(TESS)评估不良反应,并观察2组在治疗过程中是否出现呼吸抑制、肺部感染、癫痫发作、死亡等并发症。结果:治疗后7天,2组完成治疗者症状都基本缓解,疗效相当。咪达唑仑组对意识、定向、注意、兴奋躁动、自主神经功能紊乱等症状的改善快于地西泮组(P<0.05),CIWA-Ar评分在治疗后1,2,3d低于地西泮组(P<0.01)。2组均安全,不良反应及并发症少,差异比较无统计学意义(P>0.05)。结论:咪达唑仑治疗酒精所致震颤谵妄起效快,效果好,安全性较高。

OBJECTIVE To explore the efficacy and safety of midazolam in treating delirium tremens due to alcohol withdrawal. METHODS 65 patients with delirium tremens were randomly assigned to two groups and were treated with midazolam and diazepam separately by intravenous injection or minipump infusion. The efficacy was evaluated by self-made table and Revised Clinical Institute Withdrawal Assessment for Alcohol Scale （CIWA-Ar）. Side effects were measured with Treatment Emergent Symptom Scale（TESS）, and to observe whether the complications including respiratory depression, pulmonary infection, epilepsy and death occurred or not. RESULTS At the end of seventh day, two groups both got satisfactory results. The midazolam group achieved quicker effects than diazepam group in consciousness, orientation, attention, agitation, and independent nerve disfunction（P〈0. 05）, as well as the scores of CIWA-Ar were significantly lower than that in diazepam group at the first, second and third day（P〈0. 01）. The two groups had no difference in side effects and complications（P〉0. 05）. CONCLUSION Midazolam in treating delirium tremens is safe and has quick and satisfactory effects.