咪达唑仑应用于儿童PICC置管术镇静的有效性及安全性评价  

Evaluation of efficacy and safety of midazolam application calm effect in children with PICC

作　　者：钟婷[1] 钱浩 余润婷 许莹[1] 洪丽霞[1] ZHONG Ting;QIAN Hao;YU Runting;XU Ying;HONG Lixia(Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120,China)

机构地区：[1]中山大学孙逸仙纪念医院儿科,广东省广州市510120

出　　处：《护理实践与研究》2023年第3期404-408,共5页Nursing Practice and Research

基　　金：中山大学孙逸仙纪念医院护理科研项目(编号:HL2018015)。

摘　　要：目的 探讨咪达唑仑(MDZ)应用于血液肿瘤患儿PICC置管术中镇静的有效性和安全性。方法 选择医院2018年10月—2020年7月进行PICC置管的血液肿瘤患儿100例,按照组间基本特征具有可比性的原则分为对照组49例与观察组51例。对照组患儿在置管前联合应用氯丙嗪(CLP)和异丙嗪(PMT),Ramsay评分低于3分时加用地西泮;观察组患儿在PICC置管前使用MDZ,置管过程中给予维持剂量直至操作结束,比较两组镇静效果、PICC置管效果及镇静不良反应的发生率。结果 观察组镇静起效时间短于对照组,镇静一次成功率高于对照组,地西泮使用率低于对照组,MDZ镇静患儿的Ramsay评分高分比例高于对照组,组间比较差异均有统计学意义(P<0.05)。观察组的PICC置管总耗时短于对照组,组间比较差异有统计学意义(P<0.05)。患儿在给予镇静前后的生命体征均处于正常范围,且均未发生呼吸抑制等镇静不良反应。结论 咪达唑仑应用于B超引导下PICC置管术可使血液肿瘤患儿迅速进入有效、安全的睡眠状态,缩短置管耗时。Objective To evaluate the calm effect efficacy and safety of midazolam(MDZ) applied in children with hematologic tumors. Methods To select 100 children with PICC tumor catheterization in October 2018 to July 2020, they were divided into 49 cases in control group and 51 cases in observation group according to the principle of comparable basic characteristics between groups. In the control group, chlorpromazine(CLP) and promethazine(PMT) were combined before catheterization, plus diazepam when the Ramsay score was less than 3 points;in the observation group, children used MDZ before the PICC catheterization, and gave the maintenance dose until the end of the catheterization, PICC catheterization and adverse sedative reactions in the two groups.Results The onset time of sedation in the observation group was shorter than the control group, the one time success rate of sedation was higher than the control group, the utilization rate of diazepam was lower than the control group, and the proportion of Ramsay score of children with MDZ was higher than the control group,the difference between the groups was statistically significant(P<0.05). The total time consumption of PICC catheterization in the observation group was shorter than the control group, and the difference between the groups was signifcant(P<0.05). The vital signs before and after the sedation were in the normal range, and there were no adverse sedative reactions such as respiratory depression. Conclusion The application of midazolam to PICC catheterization under ultrasound guidance could quickly enter an effective and safe sleep state and shorten the time of catheterization.

关 键 词：咪达唑仑 血液肿瘤患儿 PICC置管 镇静 起效时间 一次成功率 

分 类 号：R473.72[医药卫生—护理学]