盐酸右美托咪定对婴幼儿重症肺炎镇静作用的应用研究

An Applicated Study of the Sedative Effectiveness of Dexmedetomidine Given to Infants with Severe Pneumonia

[摘要]目的：探讨盐酸右美托咪定对婴幼儿重症肺炎的镇静效果和安全性。方法：78例重症肺炎的婴幼儿分为观察组和对照组各39例，观察组使用盐酸右美托咪定微量泵持续静脉输注，剂量为0．2～0．7μg／（kg·h），对照组使用咪达唑仑，按需给予患儿每次0．1mg／kg静脉推注。采用Ramsay镇静评分法进行疗效评价。结果：（1）观察组有效率84．62％，对照组有效率87．18％。两组比较差异无统计学意义（P〉0．05）。（2）两组有效镇静的患儿用药后Ramsay评分比较，差异无统计学意义（P〉0．05）；对照组起效时间短于观察组，两组比较差异有统计学意义（P〈0．05）；对照组用药前后平均动脉压变化值大于观察组，两组比较差异有统计学意义（P〈0．05）；两组HR、RR、SpO：变化值比较差异均无统计学意义（P〉0．05）。（3）观察组患儿未见显著的心率、血压下降及呼吸抑制现象。结论：维持量的右关托咪定在婴幼儿中的镇静应用安全有效，患儿没有明显的心率、血压下降及呼吸抑制，可深入研究和逐步推广。

Objective： To investigate the sedative efficacy and safety of dexmedetomidine given to infants with severe pneumonia. Methods： Seventy-eight infants with severe pneumonia were divided into two groups, each group had 39 cases. The observation group used dexmedetumidiue and micro pump infusion at a dose of 0. 2 - 0. 7 μg/（ kg h） continuously. The control group used midazolam 0. 1 mg/（ kg hime） on-demand with intravenous injection. Efficacy was evaluated using Ramsay sedation score. Results： （1） The effectiveness of observation group and control group respectively were 86. 84% and 87. 18%, there was no statistically significant difference between two groups （P〉0. 05 ）. （2） The difference of Ramsay score was not statistically significant between the two groups after treatment （ P〉0. 05 ）. The onset time of the control group was faster than the observation group, the difference between the two groups was statistically significant （ P〈0. 05 ）. The changed value of MAP before and after treatment was greater in the eontrol group than the observation group, the difference was statistically significant （P〈0. 05 ）. The changed values of HR, RR and SpO2 between the two groups was not statistically significant （P〉 0. 05 ）. （3） Children in observation group had no significant change in heart rate, blood pressure and respiratory inhibition. Conclusion： The sedative application of the maintenance dose of dexmedetomidine in infants is safe and effective. There is no obvious change in heart rate, blood pressure and respiratory depression. It can be studied in depth and gradually extended.