口服与肌注咪达唑仑镇静治疗儿童牙科焦虑症的临床疗效对比  

Effectiveness of Oral and Intramuscular Midazolam in Treatment of Pediatric Dental Anxiety

作　　者：聂娟 陈婵婵[1] 谢静 李晨曦 刘梓枫 丁桂聪[1] NIE Juan;CHEN Chanchan;XIE Jing;LI Chenxi;LIU Zifeng;DING Guicong(Shenzhen Children's Hospital of China Medical University, Shenzhen 518026, China;University Medical Center Hamburg-Eppendorf (UKE), Hamburg 20246, Germany)

机构地区：[1]中国医科大学深圳儿童医院,广东深圳518026 [2]汉堡大学艾本德附属医院,德国汉堡20246

出　　处：《口腔医学研究》2021年第2期148-152,共5页Journal of Oral Science Research

基　　金：广东省自然科学基金(编号:2017A030310595);深圳市知识创新计划基础研究项目(编号:JCYJ20170303155435885)。

摘　　要：目的:评估咪达唑仑口服或肌注两种不同给药方法对牙科焦虑症患儿牙科治疗时的镇静效果。方法:将2020年1月~2020年7月于深圳市儿童医院口腔科接受咪达唑仑镇静下牙齿治疗的90例患儿随机分为两组,每组45例。肌注组给予肌注咪达唑仑(0.2 mg/kg),口服组给予口服咪达唑仑(0.6 mg/kg,单次最大剂量20.0 mg)。采用Ramssay量表评估患儿镇静情况,Frankl量表评估患儿治疗依从性,Houpt量表评估患儿治疗完成情况。同时记录药物起效时间、患儿治疗过程中的心率、血氧饱和度、术中及术后不良反应情况等。结果:肌注组起效时间(13.0±2.0)min明显短于口服组(15.6±1.8)min,差异有统计学意义(t=6.489,P<0.05)。两组的Ramssay量表评分中位分值(Z=-1.089,P=0.276),Frankl量表评分中位分值(Z=-0.0863,P=0.388)及Houpt量表评分中位分值(Z=-1.854,P=0.064)差异无统计学意义(P>0.05),评分分布相似。两组患儿的镇静成功率(χ^2=0.178,P>0.05)及治疗成功率(χ^2=3.103,P>0.05)差异无统计学意义(P>0.05)。两组不良反应发生率差异无统计学意义(χ^2=0.080,P>0.05)。结论:口服或肌注咪达唑仑镇静效果相似,是治疗牙科焦虑症患儿的安全有效的镇静方法,但肌注组的镇静起效更快。Objective:To evaluate the sedative effect of midazolam on dental anxiety in children treated with oral or intramuscular rout.Methods:From January 2020 to July 2020,90 children who received midazolam sedation in the Stomatology Department of Shenzhen Children's Hospital were randomly divided into two groups,45 in each group.Midazolam was given intramuscularly(0.2 mg/kg)in the intramuscular group and orally(0.6 mg/kg,maximum single dose 20.0 mg).Sedation effectiveness was assessed with the Ramsay Scale,treatment compliance with the Frankl Scale,and treatment completion with the Houpt Scale.At the same time,the onset time of drugs,heart rate,blood oxygen saturation,and intraoperative and postoperative adverse reactions were recorded.Results:The onset time of the intramuscular group(13.0±2.0min)was significantly shorter than that of oral group(15.6±1.8min,P<0.05).The median scores of the Ramsay(Z=-1.089,P=0.276),Frankl(Z=-0.0863,P=0.388),and Houpt scales(Z=-1.854,P=0.064)were not statistically significant,and the distribution of scores was similar(P<0.05).There was no significant difference in the sedation success rate(χ^2=0.178,P>0.05)and treatment success rate(χ^2=3.103,P>0.05)between two groups.And there was no significant difference in the incidence of side effects(χ2=0.080,P>0.05).Conclusions:Oral or intramuscular midazolam has similar sedative effectiveness,and both of them are safe and effective sedation methods in the treatment of dental anxiety in children,but the onset time of sedation is shorter in the intramuscular injection group.

关 键 词：牙科焦虑症 咪达唑仑 镇静 儿童牙科 

分 类 号：R47[医药卫生—护理学]