关键词: 手足口病, 呼吸,人工, 深度镇静, 咪达唑仑, 芬太尼

Abstract:

Objective  To investigate the effect of two analgesic and sedation strategies (midazolam and midazolam combined with fentanyl) in treating severe handfootmouth children with mechanical ventilation. Methods  A total of 190 children with severe handfootmouth disease treating with mechanical ventilation were selected. According to treatment program， all patients were divided into two groups， including 95 patients with midazolam  as M   group and 95 patients with midazolam combined with fentanyl as M+F group. Therapeutic effect was compared between both groups. Results  After treatment， ramsay scores were  within a reasonable range in both groups. After sedation of 2 h， 4 h， 6 h， 8 h， 10 h and 12 h， Ramsay score was closer to ideal sedation end point in M+F group than in M group (P<0.01). After sedation， PAED score was significantly decreased in both groups. As sedation time prolonged， PAED score decreased more significantly. After sedation of 2 h， 4 h， 6 h， 8 h，10 h and 12 h， PAED score was significantly lower in M+F group than in M group (P<0.01). Spontaneous breathing time， eye opening time， accurately complete instruction time， extubation time and orientation recovery time were significantly earlier in M+F group than in M  group (P<0.01). Mechanical ventilation time， ICU hospitalization time and total hospitalization time were significantly decreased in M+F group than in M group (P<0.01). Conclusion  Midazolam combined with fentanyl can obviously relieve pain， reduce agitation， shorten recovery time and treatment time and it is worthy of clinical use.

Key words: hand, foot and mouth；respiration, artificial  , disease；deep sedation；  , midazolam, fentanyl