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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 214 -217. doi: 10.3877/cma.j.issn.1674-0793.2020.03.012

所属专题： 文献；

论著

小剂量右美托咪定联合丙泊酚用于小儿门诊核磁共振检查镇静的临床研究
陈景晖1, 刘新贺2, 金尚仪3, 余高锋1,†()   
  1. 1. 510623　广州市妇女儿童医疗中心麻醉科
    2. 510510　广州，广东三九脑科医院麻醉科
    3. 510000　广州，中山大学附属第三医院岭南医院心血管内科
  • 收稿日期:2019-12-30 出版日期:2020-06-01
  • 通信作者: 余高锋

Clinical study of low-dose dexmedetomidine combined with propofol for sedation in pediatric outpatient MRI

Jinghui Chen1, Xinhe Liu2, Shangyi Jin3, Gaofeng Yu1,†()   

  1. 1. Department of Anesthesiology, Guangzhou Women and Children Medical Center, Guangzhou 510623, China
    2. Department of Anesthesiology, Guangdong 999 Brain Hospital, Guangzhou 510510, China
    3. Department of Cardiology, Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China
  • Received:2019-12-30 Published:2020-06-01
  • Corresponding author: Gaofeng Yu
  • About author:
    Corresponding author: Yu Gaofeng, Email:
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引用本文：

陈景晖, 刘新贺, 金尚仪, 余高锋. 小剂量右美托咪定联合丙泊酚用于小儿门诊核磁共振检查镇静的临床研究[J]. 中华普通外科学文献(电子版), 2020, 14(03): 214-217.

Jinghui Chen, Xinhe Liu, Shangyi Jin, Gaofeng Yu. Clinical study of low-dose dexmedetomidine combined with propofol for sedation in pediatric outpatient MRI[J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(03): 214-217.

目的

评价小剂量右美托咪定联合丙泊酚用于小儿门诊核磁共振检查（MRI）镇静的临床应用。

方法

选取2019年1月至3月在广州市妇女儿童医疗中心行门诊MRI需要镇静的患儿300例，随机分为三组：水合氯醛镇静组（H组，口服10%水合氯醛镇静）；丙泊酚静脉镇静组（P组，静脉推注丙泊酚镇静）；小剂量右美托咪定联合丙泊酚静脉镇静组（DP组，右美托咪定0.3 μg/kg+丙泊酚静脉镇静），各100例。比较三组患者的镇静成功率，镇静效果，呕吐、躁动发生率，呼吸抑制率。

结果

P组及DP组的镇静成功率明显高于H组（χ2=18.560，P<0.001），呕吐、躁动发生率明显低于H组（χ2=54.224、17.023，P<0.001、0.001），三组呼吸抑制发生率及需要呼吸支持例数差异无统计学意义（χ2=1.049、1.798，P=0.591、0.407）。DP组需追加丙泊酚例数明显少于P组（χ2=67.520，P<0.001）。镇静过程中，P组及DP组镇静起效时间、苏醒时间、苏醒至离院时间明显短于H组（F=634.100、243.800、42.930，P<0.001、<0.001、<0.001）。

结论

小剂量右美托咪定联合丙泊酚静脉镇静用于小儿门诊MRI检查，具有起效快、不良反应少、安全性高、苏醒快等优点，可在小儿门诊镇静推广应用。

关键词: 儿童, 药物镇静, 核磁共振，生物分子, 右美托咪定, 丙泊酚
Objective

To assess the clinical application of low-dose dexmedetomidine combined with propofol for sedation in pediatric outpatient MRI.

Methods

From January 2019 to March 2019, three hundred children who needed sedation for outpatient MRI in Guangzhou Women and Children's Medical Center were randomly divided into three groups: chloral hydrate sedation group (group H, oral take 10% chloral hydrate sedation), propofol sedation group (group P, propofol iv), and low-dose dexmedetomidine combined with propofol sedation group (group DP, dexmedetomidine 0.3 μg/kg iv + propofol iv), 100 cases in each group. The success rate of sedation, sedation effect, incidence of vomiting, agitation and respiratory inhibition were compared among the three groups.

Results

The sedation success rate of group P and group DP was significantly higher than that of group H (χ2=18.560, P<0.001), while the incidence of vomiting and agitation was significantly lower (χ2=54.224, 17.023; P<0.001, 0.001). There were no significant differences in the incidence of respiratory depression and the number of cases requiring respiratory support among the three groups (χ2=1.049, 1.798; P=0.591, 0.407). The number of cases requiring propofol was significantly less in group DP than in group P during the sedation (χ2=67.520, P<0.001).The sedation onset time and recovery time and discharge time of group P and group DP were significantly shorter than those of group H (F=634.100, 243.800, 42.930, all P<0.001).

Conclusion

Low-dose dexmedetomidine combined with propofol intravenous sedation for MRI examination in pediatric outpatient clinics has such advantages as fast onset, fewer adverse reactions, high safety, quick recovery, and can be widely used in pediatric sedation.

Key words: Child, Conscious sedation, Nuclear magnetic resonance, biomolecular, Dexme-detomidine, Propofol
表1 三组患儿门诊核磁共振检查镇静不良反应情况的比较［例(%)］
组别 例数 镇静失败 呼吸抑制 心动过缓 心动过速 呕吐 躁动 需要呼吸干预 需要追加丙泊酚
H组 100 9(9.0) 6(6.0) 2(2.0) 32(32.0) 28(28.0) 14(4.0) 3(3.0) —
P组 100 0(0) 5(5.0) 3(3.0) 5(5.0) 2(2.0) 2(2.0) 4(4.0) 76(76.0)
DP组 100 0(0) 3(3.0) 4(4.0) 2(2.0) 0(0) 2(2.0) 1(1.0) 18(18.0)
χ2值 ? 18.560 1.049 0.687 48.282 54.224 17.023 1.798 67.520
P值 ? <0.001 0.591 0.709 <0.001 <0.001 <0.001 0.407 <0.001
表2 三组患儿门诊核磁共振检查镇静时间的比较（min,±s ）
组别 例数 镇静起效时间 MRI检查时间 检查结束至苏醒时间 苏醒至离院时间
H组 100 15.1±5.5 15.3±5.3 20.1±5.7 35.1±5.9
P组 100 0.5±0.1 15.2±5.7 10.2±2.6 30.2±5.8
DP组 100 2.5±0.3 16.1±5.1 8.0±3.2 27.7±5.5
F值 ? 634.100 0.826 243.800 42.930
P值 ? <0.001 0.439 <0.001 <0.001
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