新生儿机械通气78例不同镇静方式的临床应用分析  

Comparison of clinical application of different sedation modes in 78 cases of neonatal mechanical ventilation

作　　者：高子波[1] 陈莹[1] 韩良荣[1] 季东林[1] 

机构地区：[1]淮安市妇幼保健院,江苏淮安223002

出　　处：《现代医药卫生》2010年第23期3564-3566,共3页Journal of Modern Medicine & Health

摘　　要：目的:比较咪达唑仑和苯巴比妥在新生儿机械通气中的镇静效果。方法:回顾性分析2008年12月～2010年3月我院NICU住院期间应用镇静药物的78例机械通气患儿资料。分为咪达唑仑组42例,苯巴比妥组36例,比较两组患儿在用药前、用药1h、6h、12h、24h、36h的疼痛行为反应评分、机械通气参数(PIP、PEEP、FIO2)和血气分析、收缩压、心率、机械通气时间、不良反应发生率。结果:两组患儿用药后疼痛行为评分明显低于用药前(P<0.05),用药后各时间段两组对比差异有统计学意义(P<0.05);咪达唑仑组PIP、PEEP、FIO2在用药后下调明显快于苯巴比妥组,两组比较差异有统计学意义(P<0.05);两组在通气时间和不良反应比较上差异无统计学意义(P>0.05)。结论:咪达唑仑比苯巴比妥能起更好的镇静作用、更快的降低呼吸机参数,达到更好的机械通气效果。Objective：To compare the effect of midazolam and phenobarbital in neonatal sedation during mechanical ventilation.Methods：A retrospective analysis was performed on the data of 78 hospitalized neonatal cases using sedative drugs during mechanical ventilation in our hospital NICU from December 2008 to March 2010.42 cases were in midazolam group,while the other 36 cases in phenobarbital group.The pain behavioral responses score at baseline,1h,6h,12h,24h,36h after medication,mechanical ventilation parameters（PIP,PEEP,FIO2） and blood gas analysis,systolic blood pressure,heart rates and side effects incidence were compared between the two groups during mechanical ventilation.Results：The pain behavioral responses scores of two groups after treatment were significantly lower than those before treatment（P0.05）,while those at different time periods had significant differences between the two groups（P 0.05）;PIP,PEEP,FIO2 decreases of midazolam groups after medication were faster than those of phenobarbital group with statistically significant difference（P0.05）;the difference of two groups in ventilation and side effects was not statistically significant（P0.05）.Conclusion：Midazolam can play better sedative effect,reduce the ventilator parameters much faster to achieve better effect of mechanical ventilation than phenobarbital.

关 键 词：咪达唑仑 苯巴比妥 机械通气 新生儿 

分 类 号：R72[医药卫生—儿科]