纳布啡静推复合右美托咪定滴鼻用于小儿静脉肾盂造影检查镇静的疗效及安全性研究  

Efficacy and safety of intravenous nalbuphine combined with dexmedetomidine nasal drops for sedation in children undergoing intravenous pyelography

作　　者：鲁海兵 贾英萍 周锐 齐金莲[1] LU Haibing;JIA Yingping;ZHOU Rui;QI Jinlian(Children's Hospital Affiliated of Zhengzhou University(Henan Children's Hospital,Zhengzhou Children's Hospital),Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学附属儿童医院(河南省儿童医院,郑州儿童医院)麻醉与围术期医学科,河南郑州450000

出　　处：《中国医学工程》2022年第3期45-48,共4页China Medical Engineering

基　　金：河南省医学科技攻关计划项目(2018020696)。

摘　　要：目的研究小儿静脉肾盂造影检查(IVP)镇静中应用纳布啡静推复合右美托咪定滴鼻的疗效及安全性。方法选取郑州大学附属儿童医院于2018年5月至2020年3月收治的84例小儿患者为研究对象,按随机数字表法分为两组,各42例。所有患儿均行静脉肾盂造影检查,对照组行纳布啡静推镇静,观察组行纳布啡静推复合右美托咪定滴鼻镇静,比较两组血流动力学、免疫功能、FLACC疼痛评分、Ramsay镇静评分及不良反应情况。结果与对照组比较,观察组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时刻FLACC评分均更低(P<0.05);与对照组比较,观察组T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时刻Ramsay评分均更低(P<0.05);与对照组比较,观察组检查后CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平均更高(P<0.05);与对照组比较,观察组麻醉后心率(HR)、平均动脉压(MAP)水平均更低(P<0.05);不良反应发生率比较,观察组(4.76%)低于对照组(23.81%)(P<0.05)。结论小儿静脉肾盂造影检查镇静中应用纳布啡静推复合右美托咪定滴鼻,可有效减轻患儿疼痛感,改善患儿镇静情况,对人体血流动力学影响较小,不良反应少,可确保镇静安全性。【Objective】To study the efficacy and safety of intravenous nalbuphine combined with dexmedetomidine nasal drops in sedation of intravenous pyelography(IVP)in children.【Methods】Eighty-four cases of pediatric patients in our hospital from May 2018 to March 2020 were selected as the research objects,and they were randomly divided into two groups,42 cases in each group.All the children underwent intravenous pyelography.The control group received intravenous sedation with nalbuphine,while the observation group received nasal sedation with nalbuphine combined with dexmedetomidine.The hemodynamics,immune function,FLACC pain score,Ramsay sedation score and adverse reactions of the two groups were compared.【Results】Compared with the control group,FLACC scores at T_(0),T_(1),T_(2),T_(3)and T_(4)in the observation group were lower(P<0.05).Compared with the control group,Ramsay scores at T_(0),T_(1),T_(2),T_(3)and T_(4)in the observation group were lower(P<0.05).Compared with the control group,the levels of CD 3^(+),CD 4^(+),CD 8^(+)and CD 4^(+)/CD 8^(+)in the observation group were higher(P<0.05).Compared with the control group,heart rate(HR),mean arterial pressure(MAP)levels in the observation group after anesthesia were lower(P<0.05).The incidence of adverse reactions in the observation group(4.76%)was lower than that in the control group(23.81%),and the difference was statistically significant(P<0.05).【Conclusion】The application of nalbuphine intravenous injection combined with dexmedetomidine nasal drops in pediatric intravenous pyelography sedation can effectively reduce the pain of children,improve the sedation of children,have less impact on human hemodynamics and less adverse reactions,which can ensure the safety of sedation.

关 键 词：纳布啡 静脉推注 右美托咪定 小儿患者 静脉肾盂造影检查 镇静效果 

分 类 号：R692.7[医药卫生—泌尿科学]