| 引用本文: | 鲍仕慧,郑映,娄鹏程,林正锋,凌颖娴.重症患儿医源性阿片类戒断的风险因素研究[J].中国现代应用药学,2020,37(3):339-343. |
| BAO Shihui,ZHENG Ying,LOU Pengcheng,LIN Zhengfeng,LING Yingxian.Risk Factors of Iatrogenic Opioid Withdrawal in Critically Ill Pediatric Patients[J].Chin J Mod Appl Pharm(中国现代应用药学),2020,37(3):339-343. |
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| 重症患儿医源性阿片类戒断的风险因素研究 |
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鲍仕慧1, 郑映1, 娄鹏程2, 林正锋1, 凌颖娴3
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1.温州医科大学附属第二医院、育英儿童医院, 药学部, 浙江 温州 325027;2.温州医科大学附属第二医院、育英儿童医院, PICU, 浙江 温州 325027;3.温州医科大学药学院, 浙江 温州 325035
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| 摘要: |
| 目的 探讨重症患儿医源性阿片类戒断（iatrogenic opioid withdrawal，IOW）的风险因素，为临床预防IOW提供依据。方法 选取2016年10月-2018年10月在重症监护室住院并接受阿片类药物连续使用≥ 5 d的患儿111例，采用临床病例资料回顾性分析的方法，收集研究对象的年龄、性别、并发症、阿片类药物用量用法及停药方式等，根据索菲亚戒断症状量表（Sophia observation withdrawal symptoms scale，SOS）进行戒断评分，对上述指标进行单因素分析，得出IOW的风险因素。结果 SOS评分≥ 4组50例，SOS评分≤ 3组61例，IOW发生率为45.05%，2组患儿的芬太尼累积剂量与是否发生戒断反应没有显著关系（P=0.1），但可认为强风险因素。2组患儿年龄、性别、并发症、维持剂量、持续时间、间歇给药、停药方式比较，差异均无统计学意义。结论 芬太尼累积剂量是IOW最具预测性的风险因素，其他因素和IOW评估关系证据不足。 |
| 关键词: 重症患儿 阿片类戒断 风险因素 |
| DOI：10.13748/j.cnki.issn1007-7693.2020.03.016 |
| 分类号:R969.3 |
| 基金项目:温州市基础性科研项目（Y20180734）；浙江省药学会医院药学专项科研项目（2017ZYY22） |
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| Risk Factors of Iatrogenic Opioid Withdrawal in Critically Ill Pediatric Patients |
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BAO Shihui1, ZHENG Ying1, LOU Pengcheng2, LIN Zhengfeng1, LING Yingxian3
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1.The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Department of Pharmacy, Wenzhou 325027, China;2.The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, PICU, Wenzhou 325027, China;3.School of Pharmaceutical Sciences, Wenzhou Medical Universitiy, Wenzhou 325035, China
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| Abstract: |
| OBJECTIVE To explore the risk factors of iatrogenic opioid withdrawal(IOW) in critically ill pediatric patients, and to provide evidences for clinical prevention of IOW. METHODS The 111 pediatric patients hospitalized in intensive care unit from October 2016 to October 2018 who received continuous opioid for ≥ 5 d were selected. The datas of dosages, complications and weaning plan of opioid use, the age and gender of these subjects were collected by retrospective analysis. The withdrawal items were scored according to the Sophia observation withdrawal symptoms scale(SOS), and the risk factors of IOW were analyzed by univariate methods. RESULTS The incidence of IOW was 45.05%, with 50 patients scores of SOS ≥ 4 and 61 patients scores ≤ 3. There were no significant differences in age, gender, complications, maintenance dose, duration of therapy, intermittent infusion, and weaning plan between the two groups. While the occurrence of withdrawal reaction of fentanyl was significantly correlated with its cumulative dose in the two groups(P=0.1). CONCLUSION Cumulative dose and duration of therapy are the most predictive risk factors of IOW. While other risk factors failed to evaluate the occurrence of IOW. |
| Key words: critically ill pediatric patients opioid withdrawal risk factors |
