水合氯醛用于小儿影像学检查时镇静的有效性和安全性

Evaluation of efficacy and safety of chloral hydrate sedation for imaging test in children

目的分析不同剂量水合氯醛原液口服用于小儿影像学检查的有效性和安全性。方法回顾性分析2011年2～4月1266例门诊行心脏彩超、CT和MRI检查口服水合氯醛镇静的患儿,评价水合氯醛50mg/kg和60mg/kg口服镇静的一次成功率和不良反应发生率。结果心脏彩超(92.9%)和CT检查(89.2%)时一次成功率明显高于MRI检查(60.0%)(P<0.05)。MRI检查时50mg/kg镇静一次成功率明显低于60mg/kg(51.5%vs.71.1%,P<0.01)。心脏彩超检查时不良反应发生率(8.7%)明显高于CT检查(2.8%)和MRI检查(1.7%)(P<0.01)。各项检查中两种剂量水合氯醛不良反应发生率差异无统计学意义。结论 50mg/kg水合氯醛口服可安全有效地用于心脏彩超和CT检查镇静,提高剂量并不能明显增加镇静的一次成功率;而60mg/kg水合氯醛可提高MRI检查镇静的一次成功率。

Objective The aim of this study was to determine the efficacy and safety of chloral hydrate （CH） with different sedation doses for imaging tests in pediatric patients. Methods A total of 1 266 pediatric outpatients sedated with echocardiography （ECHO）, CT, and MRI with oral CH were enrolled and analyzed. The success rate and adverse effects rate between CH （50 mg/kg） and CH （60 mg/kg） were compared. Results The one-time success rate of MRI（60%） was lower than CT（89.2%） and ECHO （92.9%） with sedation of oral CH （P〈0.05）. Oral CH 60 mg/kg significantly increased one-time success rate compared with 50 mg/kg for MRI （51.5% vs. 71.1%, P〈0. 05）. There was lower incidence of adverse effects with oral CH 50 mg/kg for procedures of CT （2.8G）, MRI（1.7%） compared with ECHO（8. 7%） （P（0.05）. No significant difference in the incidence of adverse effect with CH 50 mg/kg and 60 mg/kg for the same procedure. Conclusion In pediatric outpatients, oral CH 50 mg/kg was effective and safe for procedures of ECHO and CT, and for MRI larger dose of 60 mg/kg was needed.