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右美托咪定滴鼻联合七氟烷在小儿磁共振检查中镇静效果的临床分析
Clinical efficacy of dexmedetomidine combined with sevoflurane sedation in pediatric MRI scanning
- 第三军医大学学报 2020年42卷第7期 页码：730-733
- 作者机构：
400010 重庆，重庆医科大学附属儿童医院麻醉科，儿童发育疾病研究教育部重点实验室，国家儿童健康与疾病临床医学研究中心，儿童发育重大疾病国家国际科技合作基地，儿科学重庆市重点实验室
- 作者简介：
[ 刘巍. E-mail:faithrefresh@126.com LIU Wei, E-mail:faithrefresh@126.com
- 基金信息：重庆市科技计划项目(CSTC2018jscx-msybX0104)
DOI：10.16016/j.1000-5404.201910219
中图分类号： R445.2;R614;R72收稿：2019-10-31，
修回：2019-12-13，
纸质出版：2020-04-15
- 稿件说明：
移动端阅览
张甜歌, 唐文, 徐颖, 等. 右美托咪定滴鼻联合七氟烷在小儿磁共振检查中镇静效果的临床分析[J]. 第三军医大学学报, 2020,42(7):730-733.
Tiange ZHANG, Wen TANG, Ying XU, et al. Clinical efficacy of dexmedetomidine combined with sevoflurane sedation in pediatric MRI scanning[J]. Journal of Third Military Medical University, 2020, 42(7): 730-733.
张甜歌, 唐文, 徐颖, 等. 右美托咪定滴鼻联合七氟烷在小儿磁共振检查中镇静效果的临床分析[J]. 第三军医大学学报, 2020,42(7):730-733. DOI： 10.16016/j.1000-5404.201910219.
Tiange ZHANG, Wen TANG, Ying XU, et al. Clinical efficacy of dexmedetomidine combined with sevoflurane sedation in pediatric MRI scanning[J]. Journal of Third Military Medical University, 2020, 42(7): 730-733. DOI： 10.16016/j.1000-5404.201910219.
摘要
目的
2
观察右美托咪定滴鼻联合七氟烷吸入在小儿核磁共振(MRI)检查中的镇静作用与安全性。
方法
2
选择重庆医科大学附属儿童医院2019年1-6月行MRI检查的1~3岁患儿358例，其中男性192例，女性166例，分为两组:右美托咪定2 μg/kg经鼻给药联合面罩七氟烷吸入(dexmedetomidine combination with sevoflurane group，DS)组177例，右美托咪定2 μg/kg经鼻给药联合水合氯醛30 mg/kg口服(dexmedetomidine combination with chloral hydrate group，DC)组181例。记录镇静成功率、诱导时间(induction time，IT)、检查时间(total scan tim
e，ST)、苏醒时间(recovery time，RT)和完全恢复时间(time to baseline，TTB)；给药前即刻(T
0
)、检查开始时(T
1
)、检查5 min(T
2
)、检查结束时(T
3
)以及苏醒时(T
4
)的心率(heart rate，HR)和血氧饱和度(SpO
2
)；观察给药后心动过缓、呼吸抑制、恶心呕吐和苏醒躁动等不良反应的发生情况。
结果
2
两组患儿年龄、体质量、性别构成及镇静期生命体征差异无统计学意义(
P
>
0.05)。DS组镇静的成功率为97.18%，高于DC组90.61%(
P
<
0.05)；与DC组比较，DS组需重复扫描序列数减少(
P
<
0.05)，IT、RT和TTB均缩短(
P
<
0.05)；DS组家属对于重复同样镇静方法的依从性和满意度较DC组升高(
P
<
0.05)。
结论
2
右美托咪定经鼻给药联合七氟烷吸入可缩短诱导、检查和苏醒时间，成功率高。
Abstract
Objective
2
To observe the sedation effect and safety of intranasal dexmedetomidine in combination with sevoflurane inhalation for pediatric patients undergoing magnetic resonance imaging(MRI).
Methods
2
From January 2019 to June 2019
a total of 358 patients (192 males and 166 females) aged 1 to 3 years undergoing MRI scanning in our hospital were recruited in this study. According to the sedation scheme
they were divided into intranasal dexmedetomidine in combination with inhalation sevoflurane group (DS group
intranasal administration of 2 μg/kg dexmedetomidine+mask sevoflurane inhalation
n
=177) and intranasal dexmedetomidine in combination with oral chloral hydrate group (DC group
intranasal administration of 2 μg/kg dexmedetomidine+oral administration of 30 mg/kg chloral hydrate
n
=181). The success rate of sedation
induction time (IT)
total scan time (ST)
recovery time (RT)
time to baseline (TTB) were recorded. The heart rate and oxygen saturation at immediate administration (T
0
)
beginning of the inspection (T
1
)
5 min into the inspection (T
2
)
end of the inspection (T
3
) and when they wake up (T
4
) were also recorded. The incidence of adverse reactions
such as bradyc
ardia
respiratory suppression
nausea
vomiting and restlessness after administration were observed.
Results
2
There were no significant differences in the age
weight
gender composition and vital signs during sedation between the 2 groups (
P
<
0.05). The success rate of sedation in DS group was 97.18%
significantly higher than that in DC group (90.61%
P
<
0.05). The DS group needed significantly less times of repeated scanning sequences
had obviously shorter IT
RT and TTB
and obtained notably better compliance and satisfaction in the family members when compared with the DC group (all
P
<
0.05).
Conclusion
2
Intranasal dexmedetomidine combined with sevoflurane inhalation can shorten IT
ST and RT
and is of high sedation success rate for children undergoing MRI scanning.
关键词
Keywords
references
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祝瑜, 高鸿, 田磊, 等.右美托咪定滴鼻对患儿七氟醚全麻苏醒期躁动的影响: meta分析[J].中华麻醉学杂志, 2018, 38(9): 1045-1048. DOI:10.3760/cma.j.issn.0254-1416.2018.09.006.
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