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目的对比咪达唑仑和利多卡因对新生儿难治性惊厥的治疗效果。方法对2007年5月-2009年6月泸州医学院附属医院新生儿科惊厥患儿,首先静脉滴注苯巴比妥钠注射液负荷量20 mg.kg-1,若仍抽搐不止者每间隔30 min予苯巴比妥钠注射液5 mg.kg-1静脉滴注,共2次,总量达30 mg.kg-1后仍出现频繁惊厥者考虑为难治性惊厥。共69例难治性惊厥患儿,随机分为咪达唑仑组和利多卡因组。咪达唑仑组以0.05～0.10 mg.kg-1.h-1初始剂量持续泵入,利多卡因组静脉滴注负荷量为2 mg.kg-1。分别在初始剂量给予后,根据惊厥发作次数调整至有效安全剂量,并维持至减量停药。观察2组新生儿用药剂量、治疗有效性及不良反应。采用SPSS15.0软件进行统计学分析。结果咪达唑仑组35例患儿在使用咪达唑仑后有效8例,部分有效10例,无效17例,总有效率为51.43%。利多卡因组34例患儿在使用利多卡因后有效16例,部分有效8例,无效10例,总有效率达70.59%,2组比较利多卡因组疗效优于咪达唑仑组(P<0.05)。结论利多卡因比咪达唑仑更能有效控制新生儿难治性惊厥发生。
Objective To compare the therapeutic effect of midazolam and lidocaine on refractory convulsion in neonates. Methods From May 2007 to June 2009, children with neonate pediatric convulsions in Affiliated Hospital of Luzhou Medical College were enrolled in this study. First, the dose of phenobarbital sodium injection was 20 mg.kg-1. If there were still convulsions more than 30 min to phenobarbital sodium injection 5 mg.kg-1 intravenous infusion, a total of 2 times, the total amount of 30 mg.kg-1 still frequent convulsions were considered refractory convulsions. A total of 69 children with refractory convulsions were randomly divided into midazolam group and lidocaine group. The midazolam group was continuously pumped at an initial dose of 0.05-0.10 mg.kg-1.h-1, with a lidocaine infusion of 2 mg.kg-1. Respectively after the initial dose, according to the number of seizures adjusted to an effective safe dose, and maintained to reduce withdrawal. Two groups of neonatal dose, efficacy and adverse reactions were observed. SPSS15.0 software was used for statistical analysis. Results In the midazolam group, 35 cases were effective after midazolam, 8 cases were partly effective, 17 cases were ineffective and the total effective rate was 51.43%. In the lidocaine group, 34 cases were effectively treated with lidocaine, 16 cases were effective, 8 cases were partially effective, 10 cases were ineffective, and the total effective rate was 70.59%. The efficacy of lidocaine group was better than that of midazolam group P <0.05). Conclusion Lidocaine is more effective than midazolam in controlling neonatal refractory seizures.