哺乳补救用于水合氯醛镇静失败的紫绀型先天性心脏病婴儿的有效性和安全性  

Efficiency and safety of milk feeding rescue for failed chloral hydrate sedation in infants with cyanotic congenital heart disease

作　　者：李波 但颖之 张侃[1] 金立红 陈怡绮[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心麻醉科,上海200127

出　　处：《上海交通大学学报（医学版）》2018年第1期81-84,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生和计划生育委员会重要薄弱学科建设项目(2015ZB0106);上海交通大学医学院医学教育研究课题重点项目(ZD170713)~~

摘　　要：目的·评估哺乳补救法用于水合氯醛镇静失败的紫绀型先天性心脏病婴儿超声心动图检查的有效性和安全性。方法·回顾性分析上海交通大学医学院附属上海儿童医学中心2015年因不能配合超声心动图检查需要行水合氯醛镇静的1岁以下紫绀型先天性心脏病患儿的临床资料,选择其中镇静失败的患儿,每5 min记录生命体征、血氧饱和度以及不良反应,比较不同补救方法(哺乳和肌内注射苯巴比妥)的有效性和安全性。结果·所有纳入研究的水合氯醛镇静失败病例共129例,其中苯巴比妥补救病例52例,哺乳补救病例77例。哺乳补救在紫绀型先天性心脏病婴儿中的成功率为55.8%,显著高于苯巴比妥补救组的30.8%(P=0.005)。2组间不良事件发生率差异无统计学意义(P=0.565)。结论·紫绀型先天性心脏病婴儿超声心动图检查行水合氯醛镇静失败后,哺乳是一种安全有效的补救方法。Objective To evaluate the efficiency and safety of milk feeding to rescue tailed chloral hydrate sedation in infants with cyanotic congenital heart disease who underwent transthoracic eehocardiography. Methods Clinical data of the infants with known cyanotic congenital heart disease were retrospectively analyzed, who were not adequately sedated after initial dose of chloral hydrate in 2015 in Shanghai Children＇s Medical Center, Shanghai Jiao Tong University School of Medicine. Vital signs and oxygen saturations were recorded every 5 minutes, and adverse events were noted. For rescue, efficiency and safety of milk feeding were compared with phenobarbital intramuscular injection. Results A total of 129 infants were enrolled in this study. Fifty-two infants were rescued by intramuscular phenobarbital and the other 77 ones were rescued by milk feeding. The proportion of infants successfully rescued by milk feeding was 55.8%, which was higher than that of intramuscular phenobarbital （30.8%, P=0.005）. There was no statistical difference in incidence of adverse events between the two groups （P=-0.565）. Conclusion Milk feeding is an effective and safe choice for rescue sedation for infants with cyanotic congenital heart disease undergoing transthoracic echocardiography.

关 键 词：婴儿 紫绀型先天性心脏病 镇静 哺乳 

分 类 号：R459.9[医药卫生—治疗学]