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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。
Objective: To observe the clinical effect of muscle relaxants in rapid sequential induction tracheal intubation (RSI) in pediatric intensive care unit (PICU). Methods: A total of 127 PICU children with RSI before using ventilator were selected and randomly divided into conventional group, muscle relaxant group and conventional group with intravenous infusion of midazolam and fentanyl RSI, muscle relaxant group on the basis of conventional group with vecuronium bromide RSI, observed and recorded two groups of general conditions, Goldberg score, heart rate changes before and after intubation, a success rate of intubation, airway mucosal injury, Severe bradycardia (<60 beats / min) The incidence of thoracic compression, the occurrence of thoracic atrophy and the use of ventilator time, PICU residence time and mortality. Results: The Goldberg score, the change of heart rate before intubation, the success rate of primary intubation, airway mucosal damage and the time of using ventilator in two groups were significantly different (P <0.01). Severe cardiac tachycardia Slow birth rate, incidence of thoracic antrum and mortality no significant difference (P> 0.05). Conclusion: The application of muscle relaxants to children with RSI in PICU is helpful for the smooth progress of intubation. It can reduce the pain of children and promote the recovery of children. It is worthy of clinical promotion.