Efficacy and mortality in treatment of refractory generalized convulsive status epilepticus in children: A meta-analysis
Efficacy and mortality in treatment of refractory generalized convulsive status epilepticus in children: A meta-analysis
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DOI：
10.1177/088307389901400909
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发表时间：
1999-09-01
影响因子：
1.9
通讯作者：
Glauser, TA
中科院分区：
文献类型：
--
作者：
Gilbert, DL;Gartside, PS;Glauser, TA
对于儿童难治性全身性惊厥性癫痫持续状态的药物治疗选择尚无共识。对已发表文献进行荟萃分析的目的是确定药物治疗对患有这种疾病的儿童的疗效（癫痫发作停止）和死亡率的影响，控制潜在的混杂因素。111名接受地西泮、咪达唑仑、硫喷妥钠、戊巴比妥或异氟烷治疗的儿童符合严格的入选标准。地西泮的有效性显著低于其他治疗（P = 0.006）。症状性病例的总死亡率为20%，特发性病例为4%（P = 0.038）。咪达唑仑治疗患者的死亡率较低（P = 0.021），按病因分层。咪达唑仑似乎是儿童难治性全身性惊厥性癫痫持续状态初始治疗的良好选择，但根据已发表的文献，不可能将疗效和死亡率的差异仅归因于药物作用。
There is no consensus on the choice of drug treatment for refractory generalized convulsive status epilepticus in children. The objective of this meta-analysis of the published literature was to determine the effects of drug treatments on efficacy (seizure cessation) and mortality in children with this condition, controlling for potential confounding factors. One hundred eleven children, treated with diazepam, midazolam, thiopental, pentobarbital, or isoflurane, met strict inclusion criteria. Diazepam was si,significantly less efficacious than other treatments (P =.006) stratifying for etiology. Overall mortality was 20% in symptomatic cases and 4% in idiopathic cases (P =.038). Mortality was less frequent in midazolam-treated patients (P =.021) stratifying for etiology. Midazolam appears to be a good choice for initial treatment of refractory generalized convulsive status epilepticus in children, but the attribution of differences in efficacy and mortality solely to drug effect is not possible based on the published literature.