咪达唑仑在NICU机械通气中的临床价值

The clinical value of midazolam on mechanical ventilation in NICU

目的探讨咪达唑仑在新生儿重症监护病房机械通气中的应用价值。方法以我院新生儿重症监护病房接受机械通气治疗的38例患儿为研究对象,将其定为观察组(38例)使用咪达唑仑进行镇静,对照组(38例)是在基层医院使用苯巴比妥进行镇静的病例记录,动态监测比较两组患儿心率、呼吸频率、血压和血气,应用Ramsay量表对两组的镇静效果评分,统计停药后患儿完全清醒时间。结果两组用药后心率、呼吸频率、血压和血气明显好于用药前,观察组4项指标改善效果明显好于对照组,观察组镇静效率(83.2±7.2)%,机械通气时间(129.8±43.6)min,停药后完全清醒时间(62.5±8.5)min,对照组镇静效率(77.8±6.4)%,机械通气时间(131.8±42.2)min,停药后完全清醒时间(68.5±9.5)min,组间镇静效率和清醒时间比较差异显著,组间机械通气时间比较无统计学意义。结论咪达唑仑在NICU机械通气中的镇静效果良好,短期内有效稳定了患儿的呼吸循环功能,值得进步应用。

Objective To investigate the application value of midazolam on mechanical ventilation in neonatal intensive care unit. Methods 76 cases children undergoing mechanical ventilation were regarded as the research object in our hospital neonatal intensive care unit.They were randomly divided into 2 groups.Midazolam sedation was used to the observation group（38 cases）.Phenobarbital sedation was used to the control group（38 cases）.Heart rate,respiratory rate,blood pressure and the blood gas of 2 groups was dynamic monitored.Ramsay scale score was to evaluate sedative effect.Children awake time was then counted. Results Heart rate, respiratory rate,blood gas and blood pressure of 2 groups after treatment were significantly better than before treatment.The 4 indicators improvement of the observation group were significantly better than the control group.Sedation efficiency of the observation group was（83.2±7.2）%,mechanical ventilation time was（129.8±43.6）min,completely wake up time was（62.5±8.5）min.Sedation efficiency of the control group was（77.8±6.4）%,mechanical ventilation time was（131.8±42.2）min,the awake time was（68.5±9.5）min.Sedation efficiency and awake time between groups had significant difference.Mechanical ventilation time had no significant difference. Conclusion Midazolam has good sedative effect in NICU during mechanical ventilation, which stable the respiratory and circulatory function in short term,which is worthy of application.