咪达唑仑对成人癫痫持续状态的疗效观察(1)
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【摘要】 目的 探讨咪达唑仑静脉持续输注治疗成人癫痫持续状态的疗效。方法 选择23例成人癫痫持续状态作为研究对象,先予咪达唑仑0.1 mg/kg静脉注射后予0.1 mg/(kg•h)静脉持续输注,如癫痫再发作,加用咪达唑仑0.1 mg/kg静脉注射并以0.05 mg/(kg•h)幅度加量,直到惊厥控制,如果给药剂量达0.6 mg/(kg•h)时,癫痫未控制考虑无效,不再加大用药剂量。如持续24 h无癫痫发作,予逐渐减量,每12 h以0.05~0.1 mg/(kg•h)减量直至停用。所有患者同时胃肠道给予其他1至3种抗癫痫药物,并积极治疗原发病和并发症等处理。结果 13例显效,7例有效,3例无效,总有效率为86.96%,3例出现低血压,经小剂量多巴胺升压及适当补液后纠正;2例出现呼吸减慢,血氧饱和度尚维持90%以上,未予特殊处理。结论 静脉持续输注咪达唑仑是治疗癫痫持续状态的安全有效方法,值得推广。
【关键词】
咪达唑仑;癫痫持续状态;治疗
Study on the efficacy of midazolam treating status epilepticus in adults
LIN Tianlai,DING Zhirong,WEI Sican,et al.Intensive Care Unit,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China
【Abstract】 Objective To observe the efficacy of midazolam given as a continuous infusion in the treatment of status epilepticus(SE)in adults.Methods Twentythree adults with SEreceived a bolus of midazolam 0.1 mg/kg intravenously,followed by a continuous infusion of 0.1 mg/(kg•h).When the episode of seizures continued,a second bolus of midazolam 0.1 mg/kg was given intravenously,and the dose in continuous infusion was increased by 0.05 mg/(kg•h)until the seizures were brought under control.When the totoal amount of dose reached 0.6 mg/(kg•h)and the episode continued,it was reckoned ineffective and no more dose was given.When the episode disappeared for 24 hours,the dose was decresed by 0.05~0.1 mg/(kg•h)every 12 hours until it ends.Meanwhile,all patients were given one to three kinds of antiepileptic and the primary affection and related syndrome was treated accordingly.Results The midazolam worked effectively in 13 patients,and had effect on7 patients;no effect was in 3 patients.The efficacy rate came to 86.96%.Three of the patients got a low blood pressure and recoverd after given a small dose of dopamine and relevant fluid infusion;the respiration rate of two patients slowed and was not given treatment for their oxygen saturation remained above 90%.Conclusion Midazolam is an effective and safe drug to control refractory seizures in adults with SE.
【Key words】
Midazolam;Status epilepticus;Treatment ......
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