气囊肛管在婴幼儿直肠给药镇静中的应用效果观察

Clinical Observation of Balloon anal in Rectal Sedation in Infants

目的探讨气囊肛管在婴幼儿10%水合氯醛保留灌肠镇静治疗中的效果。方法选取2018年1月至2018年10月行MRI检查的婴幼儿100例,按就诊日期单双号随机进行分组,单号为对照组49例,双号为观察组51例,对照组采用一次性肛门管行保留灌肠,观察组采用气囊肛管行保留灌肠,均采用浅插法,注药后观察组、对照组分别保留10分钟同时动态进行Ramsay镇静评分,30分钟内评分达5分时协助患者完善辅助检查,比较两组镇静效果。结果 100例患儿均无药物不良反应。观察组30分钟内评分达5分者有51例,有效率100%,对照组有24例,有效率49%;灌肠后10分钟内排大便者观察组有0例,对照组有18例;药物溢出者观察组有0例,对照组有30例;有效镇静并一次完成检查者观察组有51例,对照组有24例。上述观察指标均比较差异有统计学意义(P<0. 05)。结论气囊肛管保留灌肠法镇静效果显著,无药物溢出及排便,缩短患儿完成检查等待的时间,家属易于接受,值得临床推广。

Objective To investigate the efficacy of balloon anal in sedation by retention enema of 10%chloral hydrate in infants.Methods From January to October 2018,100 infants undergoing MRI were randomized to two groups based on the date of admission.In control group(n=49,odd number of admission date),disposable rectal tube was used for retention enema;while in observational group(n=51,even number of admission date),balloon anal was used.Shallow insertion of tubes and 10-minute retention were performed in both groups.Ramsay Sedation Score(RSS)was assessed and patients were allowed to do MRI once the score reached 5 in 30 minutes.Sedation status was compared in both groups.Results No adverse events were reported.All infants(n=51,100%)in observational group had a RSS of 5 in 30 minutes and completed the MRI;while in control group there were only 24 infants(n=21,49%)(P<0.05).No stool defecation in 10 minutes after enema and medication leakage were found in observational group;while in control group,there were 18 and 30 infants,respectively(P<0.05).Conclusion Balloon anal is effective in retention enema of sedation,does not cause stool defecation and medication leakage,reduces the waiting time for tests,is easily accepted by parents,and is worthy of promotion in clinic.