持续泵入咪达唑仑及积极医护干预治疗小儿癫痫持续状态疗效研究

The Curative Effect Research about Continuous Intravenous Drip of Midazolam and Positive Health Care Intervention Treating Children with Status Epilepticus

摘要:

目的：研究咪达唑仑持续静脉泵入治疗小儿癫痫持续状态的临床疗效，同时探讨积极的医护干预对于控制感染、意识障碍及呼吸抑制等不良反应的疗效。方法：选取2011年12月~2012年10月收入院的癫痫持续状态(SE)患儿90例为观察对象，随机分为两组：治疗组46例，给予咪达唑仑持续静脉泵入，并将46例患儿随机分为两组，每组均为23例患儿，一组给予积极医护干预，另一组给予常规的医疗护理；对照组44例，仅应用传统的一线抗癫痫药物(AEDs)治疗，同样将44例患儿随机分为两组，每组均为22例患儿，一组给予积极医护干预，另一组给予常规的医疗护理，最后将两组疗效进行对照研究，并比较两种不同医护干预产生不良反应的发生概率，组间比较，最后行统计学处理。结果：治疗组治疗有效率明显高于对照组(P < 0.05)，治疗组的咪达唑仑安全有效剂量为0.1~0.5 mg/(kg·h)，积极医护干预组不良反应发生率(15.2%)明显低于对照组患儿(P < 0.05)。结论：持续静脉滴注咪达唑仑是一种安全有效的控制小儿癫痫持续状态的治疗方法，且积极的医护干预能够明显降低感染、意识障碍等不良反应的发生率，可以推广。

Abstract:  Objective: To study the clinical curative effect of the midazolam pump into vein for treating children with status epilepticus, and discuss the curative effect of the positive medical intervention to control adverse reactions such as infection, disturbance of consciousness and respiratory depression. Methods: 90 cases of status epilepticus (SE) children, who were admitted between December 2011-October 2012 as observation objects, were randomly divided into two groups: treatment group (46 cases) was given midazolam continuous intravenous pumping, and the 46 cases were randomly divided into two groups: each group composed of 23 cases, one group being given positive medical intervention, and the other group being given regular medical care; control group that has 44 cases, which were only given the traditional first-line antiepileptic drugs (AEDs) treatment, and they were randomly divided into two groups: each group composed of 22 cases, one group being given positive medical intervention, and the other group being given regular medical care. Finally, the curative effect between the two groups and the two different medical interventions in the probability of the occurrence of adverse reactions were compared. At last, comparing between groups, we made good use of the statistical soft ware to deal with the data. Result: The response rate of the efficient treatment group was obviously higher than that of the control group (P < 0.05), the treatment group of midazolam is safe and effective dosage is 0.1 to 0.5 mg/(kg·h), the positive incidence of adverse reactions (15.2%) of the medical intervention group was obviously lower than that of the control group patients (P < 0.05). Conclusions: The continuous intravenous drip of midazolam is a safe and effective control of the treatment of children with status epilepticus, and positive health care intervention can significantly reduce the incidence of infection, and adverse reactions such as disturbance of consciousness, and can be popularized.