咪达唑仑口服镇静术辅助孤独症儿童口腔治疗研究

Oral Midazolam Sedation for Autistic Pediatric Patients in Dental Treatment

目的介绍一种有效的孤独症患儿牙科治疗的辅助方法:口服咪达唑仑镇静术。方法选取完全不能配合口腔诊疗的重度孤独症患儿10例,治疗前口服咪达唑仑0.5mg/kg,待达到Ramsay 3～5分的镇静程度后开始牙科治疗,治疗全程保持口腔清洁、监测血氧饱和度及心率等生命体征,每次治疗时间控制在20～30min内,治疗结束后在诊椅上休息至镇静程度Ramsay1～2分,生命体征监测正常后由家属护送离院。结果完成此类治疗共17人次,患儿年龄(6.00±1.89)岁,体重(28.10±9.36)kg,药物起效时间(32.06±8.30)min,Houpt治疗完成情况评分(4.71±0.77)分。治疗过程基本顺利,镇静效果满意,未出现严重的不良反应及并发症。结论根据本组病例,采用口服咪达唑仑镇静术,辅助孤独症患儿牙科治疗具有一定的安全、有效性。

Objective To introduce a method to aid dental treatment for autistic children： midazolam oral sedation. Methods 10 autistic children who can not be managed under normal dental procedures were administrated oral midazolam（0.5mg/kg） before treat- ment. Once they were adequately sedated, dental treatment was carried out in outpatient. During the whole course, their finger oxygen saturation and heart rate were inspected. Painless methods were also applied. The duration of each treatment was controlled within 30min. When the procedure ended, the autistic children were inspected until recovery from sedation and then discharged with their parents. Re- sults 10 children aged 4 N 10y totally underwent 17 visits to complete all dental treatment. The average ages were （6.00 ± 1.89）y, body weight was （28.10 ± 9.36）kg and Houpt scales were （4.71 ± 0.77 ）. They were all successfully sedated and managed and no severe complications were found. Conclusion The oral midazolam sedation showed satisfactory effects on this group of autistic children while studies of large samples are needed to draw a definite conclusion.