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水合氯醛用于先心患儿心彩超检查的镇静效果观察
Efficacy observation of chloral hydrate sedation in children with congenital heart diseases undergoing echocardiography
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DOI:
作者:
金立红
jin li-hong, bian yong, zhang ma-zhong
作者单位:
上海儿童医学中心麻醉科
shanghai children's medical center
关键词:
水合氯醛,镇静,先心,安全性,有效性
Chloral hydrate; Sedation; Congenital heart diseases; Safety; Efficacy
摘要:
【摘要】 目的 水合氯醛是小儿镇静的常用药物,本研究比较其镇静的有效性和安全性在先心患儿是否存在年龄、性别、先心分型及心脏手术与否的差异。方法 回顾分析668例经水合氯醛50mg/kg口服镇静后进行心彩超检查的先心患儿资料,记录患儿的一般资料、镇静用药、用药结果和不良反应,比较患儿镇静的有效性和安全性在不同年龄(1~6月,6~12月,12~36月)、性别、不同类型的先心病(紫绀,非紫绀)以及先心术前和术后的差异。 结果 12~36月年龄组患儿一次成功率(89.8%)显著低于1~6月,6~12月两个年龄组(95.3%和95.6%,P均<0.05),三组离院时间和不良反应发生率差异未见统计学意义(P>0.05)。非紫绀型先心患儿镇静的一次成功率(94.5%)显著高于紫绀型先心患儿(89.9%),离院时间(60.7±30.3 min)较紫绀型先心患儿(68.2±36.7 min)显著缩短(P<0.05),但不良反应发生率差异无统计学意义(P>0.05)。不同性别和手术与否,患儿镇静的一次成功率、离院时间、不良反应发生率差异均未见统计学意义(P>0.05)。结论 50mg/kg水合氯醛口服可安全有效地用于先心患儿的门诊镇静,但在年龄为12~36月间及紫绀型先心的患儿镇静的成功率降低,不良反应发生率没有显著影响。性别和手术与否不影响先心患儿水合氯醛镇静的有效性和安全性。
【Abstract】 Objective Chloral hydrate is widely used as an sedative in young children. The aim of this study is to analyze the pharmacodynamic influences of age, gender, operation, cyanotic and acyanotic CHD (congenital heart disease) status on efficacy and safety of chloral hydrate in children undergoing echocardiography. Methods We selected 668 children with congenital heart disease sedated with oral chloral hydrate in our hospital. Demographics, sedation protocols, diagnosis, efficacy and adverse events were recorded, and the one-time success rate and adverse effects rate were recorded and analyzed retrospectively. Results One-time success rate of children who were 12 to 36 months old was 89.8%, significantly lower than children who were 1 to 6 months and 6 to 12 months (95.3% and 95.6%, P <0.05), but no significant difference in the hospital stay time and the incidence of adverse effects (P>0.05). Children with cyanotic CHD had lower One-time success rate than acyanotic CHD (89.9% vs. 94.4%), and longer hospital stay time (68.2±36.7min vs. 60.7±30.3min) (P<0.05), but no significant difference in the incidence of adverse effects. Children who had different genders or operations or not had similar one-time success rate, hospital stay time and the incidence of adverse effects (P>0.05). Conclusions Oral chloral hydrate 50mg/kg is effective and safe to children with heart disease. Children who are 12 to 36 months old or have cyanotic CHD have lower success rate of sedation. Gender and operation have no influence on the efficacy and safety of chloral hydrate sedation.
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