河北医学2018，Vol.24Issue(5)：734-738,5.DOI:10.3969/j.issn.1006-6233.2018.05.008
咪达唑仑联合早期机械通气治疗对重症手足口病患儿脑氧合指标肺功能指标及血清炎症因子水平的影响
Effect of Midazolam combined with Early Mechanical Ventilation on the Cerebral Oxygenation Index Lung Function and Serum Inflammatory Factors in Children with Severe Hand-Foot-Mouth Disease
摘要
Abstract
Objective:To explore the effect of midazolam combined with early mechanical ventilation on the cerebral oxygenation index,lung function and serum inflammatory factors in children with severe hand-foot-mouth disease(HFMD). Methods:60 children with severe HFMD who underwent mechanical ventilation in the pediatric intensive care unit of the hospital were randomly divided into the routine and the study group. All children were given nutritional support and anti-inflammatory treatment. On the basis, the study group was treated with intravenous injection of midazolam. The condition of hospitalization and prognosis was compared between the two groups. The cerebral oxygenation metabolism indexes, including cerebral oxygen consump-tion,cerebral oxygen extraction rate and amount of lactic acid produced in the two groups were calculated be-fore and after treatment. The lung function and serum inflammatory factors were detected. The incidence of ad-verse reactions during treatment and the prognosis were statistically analyzed. Results:The length of ICU stay and duration of mechanical ventilation in the study group was shorter than that in the control group(P<0.05). After treatment,the cerebral oxygen consumption and amount of lactic acid produced in the study group[(57. 3±9.3)%,(0.15±0.02) mmol/L] were significantly lower than those in the routine group[(67.7±12.6)%, (0.17±0.05) mmol/L], and the cerebral oxygen extraction rate [(62.3±11.2)%] was significantly higher than that in the routine group [(52.5±10.3)%] (P<0.05). The PEF, FVC and FEV1 in the study group [(86.4±7.5)%,(73.7±10.7) L,(83.7±12.3)%] were significantly higher than those in the routine group [(80.5±7.2)%,(65.7±9.8) L,(74.5±10.7)%] (P<0.05). Serum inflammatory cytokines IL-6, TNF-ɑand PCT in the study group were significantly lower than those in the normal group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (10% vs 13.3%) (P>0. 05). Conclusion:Midazolam combined with early mechanical ventilation can effectively improve the cardiop-ulmonary function and oxygenation index in children with severe HFMD,and promote their recovery.关键词
咪达唑伦/机械通气/手足口病/脑氧合指标Key words
Midazolam/Mechanical ventilation/Hand-foot-mouth disease/Cerebral oxygena-tion index引用本文复制引用
胡丹丹,何丽雅,李佩青,陶建平,杨思达..咪达唑仑联合早期机械通气治疗对重症手足口病患儿脑氧合指标肺功能指标及血清炎症因子水平的影响[J].河北医学,2018,24(5):734-738,5.基金项目
广东省科技计划项目,(编号:2017ZC0338) （编号:2017ZC0338）
