咪达唑仑联合哌替啶在9~14岁儿童支气管镜检查中的应用价值  

Application value of midazolam combined with pethidine in bronchoscopy in children aged 9-14 years

作　　者：高枫 何勤 张玲 李丽英 蓝伶俐 GAO Feng;HE Qin;ZHANG Ling;LI Liying;LAN Lingli(Department of Respiratory and Critical Care Medicine,Guangxi Guilin Peo ple’s Hospital,Guilin 541002,China)

机构地区：[1]广西桂林市人民医院呼吸与危重症医学科,广西桂林541002

出　　处：《当代医药论丛》2022年第17期113-115,共3页

基　　金：桂林市科学研究与技术开发项目20170109-5。

摘　　要：目的:观察在9~14岁儿童支气管镜检查中使用咪达唑仑联合哌替啶进行镇静镇痛的有效性及安全性。方法:将桂林市人民医院2017年至2019年收治的需进行支气管镜检查的9~14岁患儿32例纳入本研究。将其随机分为A组和B组,每组各16例患儿。在检查前,为两组患儿均雾化吸入利多卡因进行气道表面麻醉,之后视情况为A组患儿静脉注射咪达唑仑0.1~0.2 mg/kg(总量不超过10 mg)。完成注射后,开始进行支气管镜检查,检查中不再追加咪达唑仑。为B组患儿肌内注射盐酸哌替啶1 mg/kg,然后为其静脉注射咪达唑仑0.05 mg/kg。完成注射后,开始进行支气管镜检查,检查中根据患儿的情况分次追加咪达唑仑(总量不超过10 mg)。观察两组患儿血氧饱和度的变化、呼吸抑制、呛咳、气道痉挛、躁动程度、气管镜检查治疗完成情况、检查后唤醒。结果:(1)在检查过程中,A组患儿血氧饱和度较检查前下降的幅度大于B组患儿,差异有统计学意义(P<0.05)。A组患儿中有2例患儿因血氧饱和度最低下降到80%以下而不得不暂时中断检查。(2)在检查过程中,A组患儿呼吸抑制的发生率高于B组患儿,差异有统计学意义(P<0.05)。(3)在检查过程中,A组患儿明显呛咳、气道痉挛及严重躁动情况的发生率高于B组患儿,差异有统计学意义(P<0.05)。(4)两组患儿检查后唤醒遗忘的发生率相比,差异无统计学意义(P>0.05)。(5)A组患儿均因呼吸抑制、呛咳、气道痉挛、烦躁等因素而出现检查中断的情况,其中有4例患儿终止检查。B组患儿未出现检查中断的情况,均完成检查。结论:哌替啶镇痛后个体化给予咪达唑仑在9~14岁儿童支气管镜检查中的应用价值较高。Objective:To observe the efficacy and safety of midazolam combined with pethidine for sedation and analgesia in children aged 9-14 years during bronchoscopy.Methods:Thirty-two children aged 9-14 years who needed bronchoscopy in Guilin People’s Hospital from 2017 to 2019 were included in this study.They were randomly divided into group A and group B,16 cases in each group.Before examination,children in both groups were given aerosol inhalation of lidocaine for airway surface anesthesia,and then children in group A were given intravenous midazolam 0.1-0.2 mg/kg(the total amount was not more than 10 mg).After the injection was completed,bronchoscopy was performed without additional midazolam.Children in group B were intramuscular injected with pethidine hydrochloride 1 mg/kg,followed by intravenous injection of midazolam 0.05 mg/kg.After the injection was completed,bronchoscopy was performed,during which midazolam(not more than 10 m g in total)was added in fractions according to the child’s condition.The changes of blood oxygen saturation,respiratory depression,choking,airway spasm,restlessness,completion of treatment by tracheoscopy,and wake up after examination were observed in the two groups.Results:(1)During the examination,the decrease of blood oxygen saturation in group A was greater than that in group B,and the difference was statistically significant(P<0.05).In group A,two children had to stop the examination temporarily because the oxygen saturation of blood dropped below 80%.(2)During the examination,the inci dence of respiratory depression in group A was higher than that in group B,and the difference was statistically significant(P<0.05).(3)During the examination,the incidence of obvious cough,airway spasm and severe agitation in group A was higher than that in group B,and the difference was statistically significant(P<0.05).(4)There was no significant difference in the incidence of wakefulness and forgetting between the two groups(P>0.05).(5)The examination was interrupted in all the children in grou

关 键 词：咪达唑仑 盐酸哌替啶 儿童支气管镜检查 

分 类 号：R72[医药卫生—儿科]