右美托咪定滴鼻在超声下儿童肠套叠水压灌肠复位中的应用  

Application of intranasal administration of dexmedetomidine in the ultrasound-guided hydraulic enema reduction in children with intussusception

作　　者：杜文康 张传勃 成黎明[1] 张明[1] 谷海飞[1] 林丽佳 DU Wen-kang;ZHANG Chuan-bo;CHENG Li-ming;ZHANG Ming;GU Hai-fei;LIN Li-jia(Department of Anesthesiology, Kunming Children′s Hospital, Yunnan Province, Kunming 650228, China;Department of General Surgery, Kunming Children′s Hospital, Yunnan Province, Kunming 650228, China;Infection Management Office, the Third People′s Hospital of Kunming City, Yunnan Province, Kunming 650041, China)

机构地区：[1]云南省昆明市儿童医院麻醉科,云南昆明650228 [2]云南省昆明市儿童医院普外科,云南昆明650228 [3]云南省昆明市第三人民医院感染管理办公室,云南昆明650041

出　　处：《河北医科大学学报》2022年第4期444-448,共5页Journal of Hebei Medical University

基　　金：昆明市卫生健康委员会卫生科研课题项目(2019-11-04-001);昆明市卫生科技人才培养项目暨“十百千”工程培养计划[2020-SW(后备)-110]。

摘　　要：目的评价右美托咪定滴鼻镇静在超声下儿童肠套叠水压灌肠复位中的安全性和有效性。方法选取昆明市儿童医院行超声下肠套叠水压灌肠复位的患儿100例作为研究对象,随机分为2组,试验组(A组,经鼻滴入2μg/kg右美托咪定注射液)和对照组(B组,经鼻滴入等量生理盐水),记录患儿入室(T0)、滴鼻后30 min(T1)、置入一次性小儿使用灌肠复位包肛管(T2)、复位成功(T3)及苏醒离室(T4)的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)及脉搏血氧饱和度(SpO_(2)),两组不同压力复位成功率和复位时间,住院费用以及镇静后相关并发症。结果A组HR和MAP先下降后上升,B组先上升后下降。两组组间、不同时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。两组SpO_(2)呈先上升后下降趋势,组间、组间·时点间交互作用比较差异无统计学意义(P>0.05),不同时点间差异有统计学意义(P<0.05)。A组在复位压力11.1~13 kPa成功率高于B组(P<0.05),两组在复位压力13.1~15 kPa成功率差异无统计学意义(P>0.05)。两组在反流、误吸、呼吸抑制以及喉痉挛发生率比较差异均无统计学意义(P>0.05)。A组的家属满意度高于B组(P<0.05)。A组在复位时间和住院费用上均少于B组(P<0.05)。结论2μg/kg右美托咪定注射液滴鼻镇静可安全用于超声下儿童肠套叠水压灌肠复位,既提高复位成功率,又可降低住院费用,患儿家属满意度高。Objective To evaluate the safety and efficacy of intranasal administration of dexmedetomidine in the ultrasound-guided hydraulic enema reduction in children with intussusception.Methods In total,100 children with intussusception who underwent the ultrasound-guided hydraulic enema reduction in Kunming Children′s Hospital were selected as the research subjects.The patients were randomly divided into two groups:experimental group(group A,intranasal administration of 2μg/kg dexmedetomidine)and control group(group B,with an equal amount of saline).Heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO_(2))were recorded at the time of entering the room(T0),at 30 min after nasal drip(T1),at one-time enema reduction of anal canal(T2),immediately after successful reduction(T3)and at the time of leaving the room after recovery(T4).The success rate and reduction time of different pressures,hospitalization expenses and related complications after sedation were recorded.Results HR and MAP decreased initially and then increased in group A,and increased initially and then decreased in group B.There were significant differences in interaction between two groups,different time points and time points between groups(P<0.05).SpO_(2) in the two groups increased initially and then decreased.There was no significant difference in the interaction between groups and time points between groups(P>0.05),and there was significant difference between different time points(P<0.05).The success rate of group A at the reset pressure of 11.1-13 kPa was higher than that of group B(P<0.05),and there was no significant difference between two groups at the reset pressure of 13.1-15 kPa(P>0.05).There was no significant difference in the incidence of reflux,aspiration,respiratory depression and laryngeal spasm between two groups(P>0.05).The satisfaction of family members in group A was higher than that in group B(P<0.05).The reduction time and hospitalization expenses in group A were less than those in group B(P<0.05).Conclusion Int

关 键 词：肠套叠 右美托咪定 水压灌肠复位 

分 类 号：R574.3[医药卫生—消化系统]