咪唑安定联用吗啡在小儿创伤机械通气时镇静镇痛作用的临床评价

The sedative effect of midazolam combined with morphine during ventilation treatment in pediatric trauma cases

目的评价咪唑安定联用吗啡在小儿创伤机械通气中的镇静镇痛作用。方法1999年3月～2005年5月我院PICU收住创伤患儿共58例，其中咪唑安定镇静组（A组）38例，咪唑安定联用吗啡组（B组）32例。镇静水平的监测采用Ramsay镇静指数评分标准，统计A、B组分别达到理想镇静指数的例数并做显著性检验。比较两组用药期间心率、呼吸、血压、经皮氧饱和度和血气分析值。结果B组达到理想镇静水平的例数多于A组，B组血气pH值、氧分压、二氧化碳分压、心率、经皮氧饱和度均较A组改善，差别均有显著性意义。结论咪唑安定联用吗啡在小儿创伤机械通气中的镇静镇痛作用显著，值得推广。

Objective To investigate the sedative effect of midazolam combined with morphine during ventilation treatment in pediatric trauma cases. Methods Fifty-eight children with trauma had been admitted from March. 1999 to May. 2005. They were divided into midazolam （A） group and midazolam combined with morphine （B） group. Ramsay sedative scores criterion was used to monitor the level of sedative and calculate who had reached satisfied sedative effect in each group. Then the numbers were statistically compared between group A and B.At the same time, the heart rate, breath rate, blood pressure, SO2, analysis of blood gas were compared between group A and B as well. Results There were more children who had reached satisfied seda tire effect in group B than group A. The heart rate, indexes of blood gas, such as pH, PO2, PCO2, SO2 of group B were all improved compared to those of group A. The difference between two group was statistically significant （P〈0.05）. Conclusion Midazolam combined with morphine during ventilation treatment in pediatric trauma cases has obvious sedative effect and is worth spreading in clinical practice.