苯巴比妥治疗足月新生儿癫痫性惊厥合理剂量的研究

Study on the rational dose of phenobarbital in treatment of full-term neonates with epileptic convulsion

目的探讨更科学地使用苯巴比妥治疗足月新生儿癫痫性惊厥。方法选取2016年7月1日~2018年12月31日东莞市第五人民医院新生儿科收住的59例诊断为癫痫性惊厥的足月新生儿随机分组,分别使用苯巴比妥控制惊厥电临床发作(观察组)和仅控制临床发作(对照组),比较分析其疗效差异及药物不良反应。结果观察组与对照组患儿药物不良反应发生率差异无统计学意义(P> 0.05);观察组患儿在首次用药控制惊厥后惊厥复发率较对照组少,差异有统计学意义(P <0.05);控制惊厥后1周复查EEG,观察组脑电图异常程度低于对照组,差异有统计学意义(P <0.05);随访3~12个月两组患儿后遗症发生率比较,差异无统计学意义(P> 0.05)。结论使用苯巴比妥控制新生儿癫痫性惊厥在不超过最大负荷量的前提下,加大剂量以控制电-临床发作的疗效优于仅控制临床发作,两种方案对预后的影响不明显。

Objective To explored the more scientific use of phenobarbital in the treatment of full-term neonates with epileptic convulsion. Methods 59 full-term neonates who were diagnosed as epileptic convulsion and treated in department of neonatology in The Fifth People’s Hospital of Dongguan from July 1,2016 to December 31,2018 were selected and they were randomly divided into two groups.The observation group was given phenobarbital to control electro-clinical attack of convulsion while the control group was given phenobarbital to only control clinical attack.The differences in curative effects and adverse drug reactions were compared and analyzed. Results There was no statistically significant difference in the incidence of adverse drug reactions between the observation group and the control group(P > 0.05).After the first use of drugs to control convulsion,the recurrence rate of convulsion in the observation group was significantly less than that of the control group.The difference was statistically significant(P < 0.05).Electroencephalogram was reexamined at one week after control of convulsion.The abnormal degree of EEG of observation group was significantly lower than that in the control group.The difference was statistically significant(P < 0.05).There was no statistically significant difference in the incidence of sequelae between the two groups after 3-12 months of follow-up(P> 0.05). Conclusion Using phenobarbital to treat neonates with epileptic convulsion without exceeding the maximum loading dose,the curative effect of increasing dose in controlling electro-clinical attack of convulsion is better than that of only controlling clinical attack.The effect of the two regimens on prognosis is not significant.