摘要
目的探讨在ICU危重患儿机械通气中采用咪唑安定联合芬太尼的镇痛镇静效果。方法研究对象选取该院ICU在2017年11月-2018年11月期间收治的60例危重患儿,根据患儿入院顺序分为研究组与对照组,各30例。对照组采用咪唑安定等方式,研究组采用咪唑安定联合芬太尼静脉泵镇静镇痛治疗,比较两组患儿镇静镇痛效果。结果研究组心率、呼吸、平均动脉压及血氧饱和度等临床指标明显优于对照组,机械通气天数及苏醒时间短于对照组,镇静达标时间长于对照组,且用药1、3、6 h及12 h镇静效果为(1.72±0.63)级、(2.19±0.55)级级、(2.38±0.79)级、(3.01±0.59)级明显优于对照组(t=2.656 1、3.256 6、5.510 5、2.232 4,P<0.05)。研究组患儿停药后躁动及恶心的发生率均为3.33%,明显低于对照组的20.00%、26.67%(χ^2=4.043 1、6.405 2,P=0.044 3、0.144)。结论芬太尼联合咪唑安定能够改善ICU危重患儿临床指标,缩短患儿机械通气与苏醒时间,提高镇静效果,降低停药后不良反应的发生率,临床治疗安全有效。
Objective To investigate the analgesic sedative effect of midazolam combined with fentanyl in mechanical ventilation of critically ill children in ICU.Methods Sixty patients with critically ill children admitted to our hospital from November 2017 to November 2018 were enrolled in the study.The patients were divided into study group and control group according to the order of admission.The control group was treated with midazolam.The study group was treated with midazolam and fentanyl intravenous pump for sedation and analgesia.The sedative and analgesic effects of the two groups were compared.Results The clinical indexes of heart rate,respiration,mean arterial pressure and oxygen saturation were significantly better in the study group than in the control group.The mechanical ventilation days and recovery time were shorter than the control group.The sedation time was longer than the control group,and the sedative effect of the medication at 1,3,6 h and 12 h was(1.72±0.63)level,(2.19±0.55)level,(2.38±0.79)level,and(3.01±0.59)level,which was significantly better than the control group(t=2.656 1,3.256 6,5.510 5,2.232 4,P<0.05).The incidence of agitation and nausea after discontinuation of the study group was 3.33%,which was significantly lower than 20.00% and 26.67% of the control group(χ^2=4.043 1,6.405 2,P=0.044 3,0.014 4).Conclusion Fentanyl combined with midazolam can improve the clinical indicators of critically ill children in ICU,shorten the time of mechanical ventilation and recovery,improve the sedative effect,and reduce the incidence of adverse reactions after stopping the drug.The clinical treatment is safe and effective.
作者
李晓青
宋占平
李向明
LI Xiao-qing;SONG Zhan-ping;LI Xiang-ming(Children's Severe and Kespiratory Department, Jilin Children's Hospital, Jilin, Jilin Province, 132011 China)
出处
《系统医学》
2019年第14期100-102,共3页
Systems Medicine
关键词
ICU
危重患儿
咪唑安定
芬太尼
机械通气
镇静镇痛
ICU
Critically ill children
Midazolam
Fentanyl
Mechanical ventilation
Sedation and analgesia
