[1]王亚洲.吗啡对重症手足口病患儿机械通气的镇静效果和安全性研究[J].徐州医科大学学报,2019,39(07):522-525.
 Sedative effect and safety of morphine on mechanical ventilation in children with severe hand, foot and mouth disease[J].Journal of Xuzhou Medical University,2019,39(07):522-525.
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吗啡对重症手足口病患儿机械通气的镇静效果和安全性研究()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
39
期数:
2019年07期
页码:
522-525
栏目:
出版日期:
2019-06-25

文章信息/Info

Title:
Sedative effect and safety of morphine on mechanical ventilation in children with severe hand, foot and mouth disease
作者:
王亚洲
文献标志码:
A
摘要:
目的:探讨吗啡对重症手足口病(Hand-foot-mouth disease,HFMD)患儿机械通气的镇静效果和安全性。方法:将2016年6月至2018年1月于我院治疗的94例重症HFMD患儿为研究对象,按照随机数表法平均分为实验组与对照组,各47例。两组均给予机械通气和常规药物治疗,对照组在此基础上静脉给予咪达唑仑维持,实验组患儿则静脉给予吗啡维持。比较两组镇静前、镇静后1h、4h、12h及24h时的Ramsay评分,各项临床指标,机械通气治疗12h后各项指标水平及患儿预后情况。结果:两组镇静后各时间点Ramsay评分均比镇静前有所提高,且镇静后1h和4h实验组的Ramsay评分高于对照组(均P<0.05)。实验组患儿药物起效时间、达到满意镇静时间、机械通气时间和入住监护室时间均比对照组短(均P<0.05)。机械通气12h后实验组患儿氧合指数(OI)明显高于参照组,吸气峰压(PIP)低于参照组(均P<0.05)。两组不良反应发生率及死亡率相比较均无明显差异(均P>0.05)。结论:吗啡在重症HFMD患儿机械通气治疗中镇静效果显著,可以快速达到满意镇静、改善患儿缺氧症状、减少机械通气时间和入住监护室时间,且安全性良好。
Abstract:
OBJECTIVE: To investigate the sedative effect and safety of morphine on mechanical ventilation in children with severe hand-foot-mouth disease (HFMD). METHODS: 94 children with severe HFMD who were treated in our hospital from June 2016 to January 2018 were randomly divided into experimental group and control group according to the random number table method, with 47 cases in each group.Children were given mechanical ventilation and conventional drug therapy in both groups.In the control group, children were given intravenous midazolam, and those in the experimental group were given morphine intravenously.Compared the Ramsay scores before sedation, 1h, 4h, 12h and 24h after sedation, various clinical indicators,the level of various indicators and the prognosis of children after mechanical ventilation for 12h between the two groups. RESULTS: The Ramsay scores at each time point after sedation were higher than those before sedation, and the Ramsay scores of the experimental group were higher than those of the control group at 1h and 4h after sedation (P<0.05).The time of onset of the drug, the time of satisfactory sedation, the time of mechanical ventilation and the time of admission to the intensive care unit were shorter in the experimental group than in the control group (both P<0.05).After 12 hours of mechanical ventilation, the oxygenation index (OI) of the experimental group was significantly higher than that of the reference group, and the peak inspiratory pressure (PIP) was lower than that of the reference group (both P<0.05).There was no significant difference in the incidence of adverse reactions and mortality rate between the two groups (all P>0.05).CONCLUSION: Morphine has a significant sedative effect in mechanical ventilation therapy in children with severe HFMD. It can quickly achieve satisfactory sedation, improve the symptoms of hypoxia, reduce mechanical ventilation time and stay in the intensive care unit, and it is safe.
更新日期/Last Update: 2019-07-11