院前咪达唑仑肌注与水合氯醛灌肠治疗小儿急性惊厥的疗效观察

程瑶; 姚福军; 孙丽霞

doi:10.13201/j.issn.1009-5918.2019.07.014

院前咪达唑仑肌注与水合氯醛灌肠治疗小儿急性惊厥的疗效观察

- 1. 秦皇岛市第一医院院前急救科(河北秦皇岛, 066000);
- 2. 秦皇岛市第一医院急诊科;
- 3. 华北理工大学附属医院急诊科
基金项目:
秦皇岛市科技支撑计划项目(No:201805A019)

详细信息

通讯作者: 孙丽霞,E-mail:13323151999@189.cn

中图分类号: R720.597

收稿日期: 2018-11-28

Therapeutic effect of pre-hospital midazolam intramuscular injection and chloral hydrate enema on children with acute convulsion

- 1 Department of Pre-hospital Emergency, the First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, China;
- 2 Department of Emergency, the First Hospital of Qinhuangdao;
- 3 Department of Emergency, North China University of Science and Technology Affiliated Hospital

More Information

Corresponding author: SUN Lixia, E-mail: 13323151999@189.cn

Received Date: 28 November 2018

摘要

摘要: 目的: 比较院前咪达唑仑肌注与水合氯醛灌肠治疗小儿急性惊厥的疗效及安全性,探讨院前救治小儿急性惊厥安全、高效的治疗方法。方法: 回顾性分析秦皇岛市第一医院院前急救科2015-06—2018-05期间院前接诊的需要止惊处置的急性惊厥患儿94例,按止惊措施分为咪达唑仑组(M组)和水合氯醛组(C组)。院前常规治疗基础上,M组(48例)给予咪达唑仑0.2mg·kg^-1肌肉注射,C组(46例)予10%水合氯醛0.5ml·kg^-1灌肠,比较两组临床疗效及不良反应。结果: M组有效率93.8%,C组有效率91.3%,1min、3min、5min、10min控制例数(5vs.4,24vs.19,38vs.34,45vs.42),惊厥控制时间[(3.21±1.97)min vs.(3.57±2.12)min],两组比较差异无统计学意义(P>0.05);M组复发例数、维持治疗例数均少于C组,差异有统计学意义(5vs.12,8vs.16,P<0.05);两组患儿均无明显不良反应发生。结论: 咪达唑仑肌注和水合氯醛灌肠对院前小儿急性惊厥同样安全有效,但咪达唑仑肌注操作更便捷,稳定性更高,更适用于院前急救。
- 咪达唑仑 /
- 水合氯醛 /
- 院前急救 /
- 惊厥 /
- 小儿
Abstract: Objective: To compare the efficacy and safety of midazolam intramuscular injection and chloral hydrate enema in the prehospital treatment of acute convulsion in children and to explore a safe and effective treatment for acute convulsion in children before hospitalization.Method: From Jun.2015 to May 2018,the clinical cases of 94 children with acute convulsion requiring anticonvulsive treatmentin the pre-hospital emergency department of the First Hospital of Qinhuangdao were collected and retrospectively analyzed.All patients were randomly divided into the midazolam group(group M,n=48)and the chloral hydrate group(group C,n=46)according to according to anticonvulsive measures.On the basis of the conventional prehospital treatment,group M were treated with 0.2 mg·kg^-1 im midazolam,while group C were treated with 0.5 ml·kg^-1 per chloral hydrate.The clinical efficacy and adverse reactions were compared.Result: No significant difference in effective rate and convulsion control time were found between two groups[93.8%vs.91.3%,(3.21±1.97)min vs.(3.57±2.12)min,P>0.05];There were no significant difference in the control cases of 1 min,3 min,5 min and 10 min between two groups(5 vs.4,24 vs.19,38 vs.34,45 vs.42,P>0.05);Recurrent cases and the number of cases requiring maintenance treatment were significantly less in group M than in group C(5 vs.12,8 vs.16,P>0.05);There were no obvious adverse reactions in both groups.Conclusion: Midazolam intramuscular injection and chloral hydrate enema are equally safe and effective for anticonvulsive in the prehospital setting.However,midazolam intramuscular injection is more convenient and more stable,higher stability,and is more suitable for pre-hospital first aid.
- midazolam /
- chloral hydrate /
- pre-hospital care /
- convulsion /
- children

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