瑞马唑仑与咪达唑仑对先天性心脏病患者术后谵妄的影响

The Effects of Reminazolam and Midazolam on Postoperative Delirium in Patients with Congenital Heart Disease

目的探索瑞马唑仑与咪达唑仑对先天性心脏病术后患者谵妄发生的影响。方法将2023年3~8月上海交通大学医学院附属上海儿童医学中心收治的131例先天性心脏病术后患者,随机分为瑞马唑仑组(n=66)和咪达唑仑组(n=65)。采用儿童康奈尔谵妄评估量表评估术后谵妄,分析比较两组患者的发生率、出现时间及持续时间,并记录患者药物不良反应、机械辅助通气时间、心脏重症监护室(cardiac intensive care unit,CICU)滞留时间及住院时间。结果咪达唑仑组谵妄发生率为51.7%,瑞马唑仑组为40.0%,差异无统计学意义。然而,两组谵妄发生时间点存在差异(χ^(2)=12.400,P=0.030),瑞马唑仑组的谵妄持续时间显著缩短(χ^(2)=14.773,P=0.034)。在机械通气和CICU滞留时间上两组比较,差异无统计学意义。住院时间上两组有差异性(z=0.096,P=0.016)。不良反应方面,咪达唑仑组有2例(3.08%),瑞马唑仑组有5例(7.58%),差异无统计学意义。结论瑞马唑仑作为苯二氮类药物,在先天性心脏病术后患者中对于术后谵妄存在一定保护作用。然而,瑞马唑仑在儿童中的应用仍需进一步研究,包括药物剂量和不良反应等方面。

Objective The purpose of this study is to explore the effects of reminazolam and midazolam on the occurrence of delirium in postoperative patients with congenital heart disease.Methods A total of 131 postoperative patients with congenital heart disease were admitted to our hospital from March to August 2023,they were randomly divided into a reminazolam group(n=66)and a midazolam group(n=65).The Cornell Delirium Assessment Scale for Children was used to evaluate postoperative delirium.We analyzed and compared the incidence,occurrence time,and duration of the two groups.We also recorded the patient′s adverse drug reactions,mechanical ventilation time,cardiac intensive care unit(CICU)stay time,and hospitalization time.Results The incidence of delirium was 51.7%in the midazolam group and 40.0%in the reminazolam group,with no statistically significant difference.However,there were significant differences in the timing of delirium occurrence between the two groups(χ^(2)=12.400,P=0.030).The duration of delirium in the reminazolam group was significantly shortened(χ^(2)=14.773,P=0.034).There was no statistically significant difference between the two groups in mechanical ventilation and CICU retention time.There was a difference in hospitalization time between the two groups(z=0.096,P=0.016).There were 2 cases of adverse reactions(3.08%)in the midazolam group and 5 cases(7.58%)in the reminazolam group,with no statistically significant difference.Conclusion As a benzodiazepine drug,reminazolam has a certain protective effect on postoperative delirium in patients undergoing congenital heart surgery.However,further research is needed on the application of reminazolam in children,including drug dosage and adverse reactions.