摘要
目的探讨咪达唑仑在小儿纤维支气管镜检查中的镇静效果。方法选取2018年4月至2020年1月在秦皇岛市第一医院接受纤维支气管镜检查的100例患儿为研究对象,采用随机数字表法分为对照组(采用利多卡因雾化吸入麻醉)和观察组(采用咪达唑仑联合利多卡因雾化吸入麻醉),每组50例。比较两组用药前、支气管镜检查结束后15 min、4 h的第一秒用力呼气量(FEV 1)、用力肺活量(FVC)、FEV 1/FVC,两组用药前、支气管镜进声门后、检查结束后1 min的心率、呼吸频率、脉搏血氧饱和度(SpO_(2)),两组用药前、支气管镜进声门后、检查结束后1 min的Ramsay镇静评分,以及支气管镜检查中不良反应发生率。结果FEV 1、FVC、FEV 1/FVC时点间、组间的主效应差异有统计学意义(P<0.05或P<0.01),组间和时点间存在交互作用(P<0.01),两组检查结束后15 min的FEV 1、FVC、FEV 1/FVC均明显低于用药前(P<0.05),两组各时点间比较差异无统计学意义(P>0.05)。心率和呼吸频率时点间、组间的主效应差异有统计学意义(P<0.05或P<0.01),组间和时点间存在交互作用(P<0.01),两组支气管镜进入声门后心率、呼吸频率较用药前明显升高(P<0.05),但观察组支气管镜进入声门后心率、呼吸频率均明显低于对照组(P<0.05);SpO_(2)组间、时点间、组间和时点间交互作用比较差异均无统计学意义(P>0.05)。Ramsay镇静评分时点间、组间的主效应差异有统计学意义(P<0.01),时点间与组间存在交互作用(P<0.01),两组支气管镜进声门后、检查结束后1 min的Ramsay镇静评分均明显高于用药前(P<0.05),且观察组高于对照组(P<0.05)。观察组不良反应发生率明显低于对照组[8.0%(4/50)比38.0%(19/50)](χ^(2)=21.189,P<0.001)。结论咪达唑仑用于小儿纤维支气管镜检查的麻醉镇静效果较好,对患儿气道影响小,且支气管镜检查过程中患儿呼吸、心率平稳,不良反应发生率较低。
Objective To investigate the sedative effect of midazolam in children undergoing fiberoptic bronchoscopy.Methods A total of 100 children who underwent bronchofibroscopy in Qinhuangdao First Hospital from Apr.2018 to Jan.2020 were included.The 100 children were divided into a control group(lidocaine aerosol inhalation anesthesia)and an observation group(midazolam combined with lidocaine aerosol inhalation anesthesia)by random number table method,with 50 cases in each group.The forced expiratory volume in first second(FEV 1),forced vital capacity(FVC)and FEV 1/FVC ratio before administration,15 min and 4 h after the end of bronchoscopy of the two groups were compared,the heart rate,respiratory rate,and pulse oxygen saturation(SpO_(2)),the Ramsay sedation score before administration,after bronchoscope into the glottis,and 1 min after the end of bronchoscopy of the two groups,as well as the incidence of adverse reactions during bronchoscopy of the two groups were compared.Results The main effects of FEV 1,FVC and FEV 1/FVC between time points and between groups were statistically significant(P<0.05 or P<0.01),and there was interaction between groups and time points(P<0.01).The FEV 1,FVC and FEV 1/FVC in both groups were significantly lower than before treatment 15 min after the examination(P<0.05).There was no significant difference between the two groups at each time point(P>0.05).The main effects of heart rate and respiratory rate between time points and between groups were statistically significant(P<0.05 or P<0.01),and there was interaction between groups and time points(P<0.01).The heart rate and respiratory rate of the two groups were significantly increased after bronchoscopy into the glottis compared with that before treatment(P<0.05).However,the heart rate and respiratory rate of the observation group were significantly lower than those of the control group after bronchoscopy into the glottis(P<0.05).There were no significant differences in SpO_(2) interaction between groups,time points,groups and time point
作者
刘连杰
杜然
王心妹
朱爱红
张继红
郭利丽
陈姣
LIU Lianjie;DU Ran;WANG Xinmei;ZHU Aihong;ZHANG Jihong;GUO Lili;CHEN Jiao(Department of Pediatrics,Qinhuangdao First Hospital,Qinhuangdao 066000,China;Department of Cardiology,Qinhuangdao First Hospital,Qinhuangdao 066000,China;Department of Dermatological,Qinhuangdao First Hospital,Qinhuangdao 066000,China)
出处
《医学综述》
CAS
2023年第8期1640-1644,共5页
Medical Recapitulate
基金
秦皇岛市科学技术研究与发展计划(202004A091)。
关键词
纤维支气管镜检查
咪达唑仑
麻醉镇静效果
肺功能
Fiberoptic bronchoscopy
Midazolam
Anesthetic sedation effect
Pulmonary function
