右美托咪定用于小儿机械通气镇静效果的临床研究  

Clinical efficacy of dexmedetomidine in the mechanical ventilation for children

作　　者：杜继宇[1] 赵荣香[1] 陈凤钦[2] 

机构地区：[1]绵阳市中心医院儿科,四川绵阳621000 [2]福建医科大学教学医院福州儿童医院消化专科,福建福州350004

出　　处：《临床肺科杂志》2016年第3期389-391,共3页Journal of Clinical Pulmonary Medicine

基　　金：福建省科技基金项目(No 2008-s-81)

摘　　要：目的对比研究右美托咪定与咪达唑仑在小儿重症肺炎机械通气时的镇静效果及不良反应。方法重症肺炎需要机械通气的患儿50例，随机分为右美托咪定组（观察组）及咪达唑仑组（对照组），每组25例。观察组患儿静脉注射负荷剂量盐酸右美托咪定0．5ug／kg，继之以0．2—0．5ug／kg．h持续静脉泵注。对照组患儿静注咪达唑仑0．3mg／kg，持续静脉泵注咪达唑仑0．03～0．5mg／kg／h维持。观察镇静期间血流动力学参数变化、Ramsay镇静评分及不良反应发生情况。结果两组患儿Ramsay镇静评分均明显高于用药前，用药后1h右美托咪定组患儿镇静评分明显高于咪达唑仑组（P〈0．01）。用药后两组患儿心率、血压均明显低于用药前，且右美托咪定组患儿心率明显低于咪达唑仑组患儿（P〈0．05）。停药后右美托咪定组患儿苏醒时间明显短于咪达唑仑组（P〈0．01）。不良反应发生率在两组间比较无统计学差异。结论右美托咪定在小儿重症肺炎机械通气中的镇静效果优于咪达唑仑，无严重不良反应，值得临床推广应用．Objective To compare the clinical efficacy and safety between dexmedetomidine and midzolam for children undergoing mechanical ventilation. Methods 50 children with mechanical ventilation were randomly divided into the groups D and M. The group D received an intravenous bolus injection of 0. 5 ug/kg of dexmedetomidine, and 0. 2 - 0. 5 ug/kg, h of dexmedetomidine continuously intravenous infusion for sedation. In the group M, intravenous 0. 3 mg/kg of midzolam was given to the children, and then 0. 03 - 0. 5 mg/kg, h of midzolam continuous infusion during mechanical ventilation. The Ramsay sedation scores were recorded. Changes in MAP, HR, RR and SpO2 during ventilation treatment were observed. The side effect was also assessed. Results The sedation scores of both groups were significantly higher than those before of the use of sedative agents. The time to full sedation was longer in the group M than in the group D. MAP and HR decreased significantly after sedation in both groups. HR was significantly lower in the group D than in the group M. The awakening time was significantly longer in the group M than in the group D. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion In children undergoing mechanical ventilation, dexmedetomidine is safe and effective for sedation and without seriously side effect.

关 键 词：右美托咪定 小儿 机械通气 重症肺炎 

分 类 号：R726.1[医药卫生—儿科]