地西泮静脉推注与咪达唑仑肌肉注射治疗小儿惊厥的效果比较

Comparison of effects of diazepam intravenous injection and midazolam intramuscular injection in the treatment of pediatric convulsions

目的比较地西泮静脉推注与咪达唑仑肌肉注射治疗小儿惊厥的临床效果。方法回顾性抽取2022年1月至2023年9月南阳市第二人民医院收治的惊厥患儿73例,依据治疗方案分为地西泮组(40例)和咪达唑仑组(33例)。地西泮组采用地西泮静脉推注治疗,咪达唑仑组采用咪达唑仑肌肉注射治疗。比较两组治疗效果、药物起效时间、住院时间、血清C反应蛋白水平、免疫功能[免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]及不良反应发生率。结果咪达唑仑组总有效率(93.94%,31/33)高于地西泮组(67.50%,27/40),差异有统计学意义(P<0.05)。咪达唑仑组药物起效时间、住院时间、止抽后至清醒时间短于地西泮组(P<0.05)。治疗后,咪达唑仑组C反应蛋白水平低于地西泮组(P<0.05)。治疗后,咪达唑仑组IgM、IgG水平低于地西泮组(P<0.05)。咪达唑仑组不良反应发生率(3.03%,1/33)低于地西泮组(22.50%,9/40),P<0.05。结论与地西泮静脉推注比较,咪达唑仑肌肉注射治疗小儿惊厥的效果更好,能缩短药物起效时间和住院时间,调节血清CRP水平和免疫功能,且安全性较好。

Objective To compare the clinical effects of diazepam intravenous injection and midazolam intramuscular injection in the treatment of pediatric convulsions.Methods A total of 73 children with convulsions treated in Nanyang Second General Hospital from January 2022 to September 2023 were retrospectively selected,and the children were divided into diazepam group(40 cases)and midazolam group(33 cases)according to the treatment regimen.The diazepam group was treated with diazepam intravenous injection,while the midazolam group was treated with midazolam intramuscular injection.The curative effect,onset time of drug,hospital stay,level of serum C-reactive protein(CRP),immune function,including immunoglobulin M(IgM),immunoglobulin G(IgG)and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the midazolam group was 93.94%(31/33),higher than the 67.50%(27/40)of the diazepam group(P<0.05).Compared with the diazepam group,the onset time of drug,length of hospital stay and time from stopping shaking to regaining consciousness in the midazolam group were shorter,while the level of C-reactive protein in the the midazolam group was lower after treatment(P<0.05).After treatment,the levels of IgM and IgG in the midazolam group were lower than those in the diazepam group(P<0.05).The incidence of adverse reactions in the midazolam group was 3.03%(1/33),lower than the 22.50%(9/40)in the diazepam group(P<0.05).Conclusions Compared with diazepam intravenous injection,midazolam intramuscular injection is more effective in the treatment of convulsion in children.It can shorten the onset time of drug and length of hospital stay,regulate serum level of C-reactive protein,and correct immune function,with better safety.