| 摘要: |
| 目的：观察肌松药用于儿童重症监护室（PICU）行快速顺序诱导气管插管（RSI）中的临床效果。方法：选取127例PICU使用呼吸机前进行RSI的患儿，按是否加用肌松药随机分为常规组、肌松药组，常规组先后静脉推注咪达唑仑和芬太尼后行RSI，肌松药组在常规组基础上加用维库溴铵后行RSI，观察并记录两组一般情况、Goldberg评分、插管前后心率变化、一次插管成功率、气道黏膜损伤情况、严重心动过缓（<60次/分）进行胸外按压发生率、发生胸廓强直情况及使用呼吸机时间、PICU停留时间和病死率。结果：两组患儿Goldberg评分、插管前后心率变化、一次插管成功率、气道黏膜损伤情况及使用呼吸机时间、PICU停留时间比较差异有统计学意义（P<0.01）；严重心动过缓发生率、胸廓强直发生率和病死率比较差异无统计学意义（P>0.05）。结论：肌松药应用于PICU中行RSI的患儿有助于使插管顺利进行，能减轻患儿的痛苦、促进患儿康复，值得临床推广。 |
| 关键词: 快速顺序气管插管 肌松药 儿童 重症 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2017.07.011 |
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| 基金项目: |
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| Application of Muscle Relaxants During Induced Rapid Sequential Endotracheal Intubation in PICU |
| Jiang Fengzhi, Liu Weidong, Deng Haohui |
| (Dongguan Maternal and Child Healthcare Hospital , Guangdong Dongguan 523000, China) |
| Abstract: |
| Objective: The purpose of this study was to observe the clinical effect of muscle relaxant for rapid sequence induction tracheal intubation (RSI) in pediatric intensive care unit (PICU). Methods: 127 cases of children with RIS before using ventilator were divided into two groups randomly, conventional group and muscle relaxant group, conventional group was sequential injected with intravenous injection of fentanyl and midazolam before RSI, muscle relaxant group was was sequentially injected with intravenous injection of fentanyl, midazolamand and vecuronium before RSI. Observe and record general situation, Goldberg score, heart rate before and after intubation, a success rate of intubation, airway mucosa injury, severe bradycardia (<60/min) needing chest compressions incidence, occurrence of thoracic rigidity, the respirator time, PICU stay time and mortality. Results: Goldberg score, heart rate variability, a success rate of intubation, airway mucosal injury, the ventilator time and PICU residence time showed significant difference between two groups (P<0.01); the incidence of severe bradycardia, incidence of thoracic rigidity and mortality showed no significant difference (P>0.05). Conclusion: The application of muscle relaxants in children with RSI in PICU can help to smooth the intubation, alleviate the pain and promote the rehabilitation of children. In the other way, the application of muscle relaxants also contributes to skill training of young doctors, worthy to recommand its clinical use. |
| Key words: rapid sequential endotracheal intubation muscle relaxants children intensive care |
