右美托咪定滴鼻联合咪达唑仑在危重患儿急诊转运中的应用

Application of Dexmedetomidine Nasal Drops Combined with Midazolam in Emergency Transport of CriticallyⅢChildren

目的:探讨右美托咪定滴鼻联合咪达唑仑在危重患儿急诊转运中的应用。方法:选取2021年1月—2022年5月广西壮族自治区妇幼保健院急诊转运的120例患儿。根据随机数表法将其分为对照组和观察组,各60例。两组均进行急诊转运,转运途中根据患儿基础疾病及病情做程序化镇静处理,对照组给予咪达唑仑注射液,观察组在对照组基础上给予盐酸右美托咪定注射液滴鼻。比较两组镇静效果,给药前、给药15 min、30 min后的生命体征,最低心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱合度(SpO_(2))发生时间、持续时间。结果:观察组镇静起效时间、达到目标镇静效果时间均早于对照组,差异均有统计学意义(P<0.05)。给药15 min、30 min后,两组HR、SBP、DBP、SpO_(2)均降低,但观察组HR、SBP、DBP、SpO_(2)均高于对照组,差异均有统计学意义(P<0.05)。观察组最低HR、SBP、DBP、SpO_(2)发生时间均早于对照组,持续时间均短于对照组,差异均有统计学意义(P<0.05)。结论:右美托咪定滴鼻联合咪达唑仑具有良好的镇静效果,可有效维持危重患儿急诊转运中生命体征稳定,避免机体循环紊乱,增加转运安全性。

Objective:To investigate the application of Dexmedetomidine nasal drip combined with Midazolam in emergency transport of critically ill children.Method:From January 2021 to May 2022,120 critically ill children of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region who underwent emergency transport were selected.According to the random number table method,they were divided into control group and observation group,60 cases in each group.Both groups underwent emergency transport,and programmed sedation action was performed according to the basic diseases and conditions of children during transport.The control group was given Midazolam Injection,and the observation group was given Dexmedetomidine Hydrochloride Injection nasal drip on the basis of the control group.The sedative effect,vital signs before administration,after 15 min and 30 min of administration,minimum heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),blood oxygen saturation(SpO_(2))occurrence time and duration were compared between the two groups.Result:The onset time of sedation and the time to achieve the target sedation effect in the observation group were earlier than those in the control group,and the differences were statistically significant(P<0.05).After 15 min and30 min of administration,HR,SBP,DBP and SpO_(2) in the two groups were decreased,but the HR,SBP,DBP and SpO_(2) in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The occurrence time of minimum HR,SBP,DBP and SpO_(2) in the observation group were earlier than those in the control group,and the duration was shorter than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine nasal drip combined with Midazolam has a good sedative effect,which can effectively maintain the stability of vital signs in emergency transport of critically ill children,avoid the body circulation disorder,and increase the safety of transport.