适当镇静与完全肌松在患儿长途转运中的应用对比  

Comparison of the Application of Proper Sedation and Total Muscle Relax⁃ation in Long-distance Transportation of Children

作　　者：苏玉恒 邓秀丽 李猛 黄仁壮 陈延豪 SU Yuheng;DENG Xiuli;LI Meng;HUANG Renzhuang;CHEN Yanhao(Department of Emergency,Xiangzhu District of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530012,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西壮族自治区妇幼保健院厢竹院区急诊科,广西南宁530012

出　　处：《系统医学》2024年第20期121-124,共4页Systems Medicine

基　　金：广西壮族自治区卫生健康委自筹经费科研课题(Z-A20230319)。

摘　　要：目的探讨适当镇静与完全肌松在患儿长途转运中的应用价值。方法非随机选取2021年5月—2023年9月广西壮族自治区妇幼保健院厢竹院区100例长途转运需要机械通气的患儿为研究对象。按照接受适当镇静与接受完全肌松的情况分为两组,各50例。适当镇静组采用咪达唑仑联合枸橼酸芬太尼注射液镇静,完全肌松组采用注射用维库溴铵联合咪达唑仑注射液保持肌松状态。比较两组患儿转运过程中呼吸系统意外发生率情况、转运过程中患儿躁动、坠床、气管导管移位情况、到达目的地后血气分析结果变化。结果适当镇静组呼吸系统意外总发生率为2.00%(1/50),低于完全肌松组的14.00%(7/50),差异有统计学意义(t=4.396,P<0.05)。两组发生躁动、坠床、气管导管移位的总发生率相比,差异无统计学意义(P均>0.05)。到达目的地后,适当镇静组患儿动脉血氧分压、pH值高于完全肌松组,动脉血二氧化碳分压低于完全肌松组,差异有统计学意义(P均<0.05)。结论适当镇静干预对于需要长途转运的机械通气患儿,可更好的维持患儿氧合,促进二氧化碳排除,并减少呼吸系统以及躁动、坠床、气管导管移位等不良事件发生。Objective To explore the application value of proper sedation and total muscle relaxation in long-distance transportation of children.Methods A total of 100 pediatric patients requiring long-distance transport with mechani-cal ventilation admitted to the Xiangzhu Branch of Hospital of Guangxi Zhuang Autonomous Region Maternal and Child Health from May 2021 to September 2023 were non-randomly selected as the study subjects.The patients were divided into two groups based on whether they received appropriate sedation or complete muscle relaxation,with 50 cases in each group.The appropriate sedation group was treated with midazolam combined with fentanyl citrate injec-tion,and the complete muscle relaxation group was treated with vecuronium besilate combined with midazolam injec-tion to maintain muscle relaxation.The incidence of respiratory system complications during transport,as well as agita-tion,falling from the bed,and tracheal tube displacement,were compared between the two groups.Additionally,changes in blood gas analysis results upon arrival at the destination were evaluated.Results The total incidence of re-spiratory system complications in the appropriate sedation group was 2.00%(1/50),which was lower than the 14.00%(7/50)in the complete muscle relaxation group,the difference was statistically significant(t=4.396,P<0.05).There were no statistically significant differences in the total incidence of agitation,falling from the bed,and tracheal tube displacement between the two groups(all P>0.05).Upon arrival at the destination,the arterial partial pressure of oxy-gen and pH levels in the appropriate sedation group were higher than those in the complete muscle relaxation group,while the arterial partial pressure of carbon dioxide was lower,the differences were statistically significant(all P<0.05).Conclusion Appropriate sedation intervention in pediatric patients requiring long-distance transport with me-chanical ventilation can better maintain oxygenation,promote carbon dioxide elimination,and reduce the inci

关 键 词：长途转运 机械通气 适当镇静 肌肉松弛 

分 类 号：R72[医药卫生—儿科]