机械通气患儿应用咪达唑仑的临床观察

Clinical investigation of Midazolam in mechanical ventilation inchildren.

目的 探讨危重患儿在机械通气时应用咪达唑仑的临床效果。方法 我院儿童重症监护病房 (PICU)行机械通气的 31例患儿 ,使用咪达唑仑前后进行Ramsay评分并观察心率、血压、呼吸、无创性血压、经皮氧饱和度测定及动脉血气分析 ,评价其镇静效果。结果 应用咪达唑仑后 ,能有效维持机械通气患儿镇静状态 ,无明显副作用 ,且可改善患儿动脉血血气结果、减慢呼吸频率和心率。Ramsay评分显示用药后 10min即有统计学意义 (P <0 .0 1) ,30min后则无显著性差异。结论 咪达唑仑是一种比较理想的镇静药物 ,能提高患儿对气管插管和机械通气的耐受性 ,进而提高机械通气的效果 ,有利于提高危重患儿的抢救成功率。

Objective To explore the clinical effect of Midazolam in mechanical ventilation in emergency children.Methods Thirty-one children undergoing mechanical ventilation were selected as subjects in PICU. The calm effect of Midazolam was evaluated through Ramsay grade and the heart rate, blood pressure, respiration rate, percutaneous oxygen saturation, artery blood gas analysis before and after using Midazolam were measured. The statistical analysis was carried out by matched-pair t-test.Results Midazolam could keep the patients calm effectively without side-effect, improve their artery blood gas results and decline respiration rate and heart rate. Ramsay grade revealed that there was statistical significance after using Midazolam for 10 min (P< 0.01 ), and no significance after 30 min. Conclusion Midazolam is an effective calmative and can improve the patients' tolerance to endotracheal intubation and mechanical ventilation. It can also improve the effect of mechanical ventilation and the rate of success in emergency treatment.