短期睡眠剥夺对提高儿童听性脑干反应检测成功率的研究
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摘要
目的探讨单独的睡眠剥夺或联合使用水合氯醛镇静在儿童听性脑干反应(ABR)检查中的可行性和有效性。方法回顾性分析2012—2016年在西南医科大学附属医院进行ABR检查儿童的听力学资料。根据ABR测试前睡眠剥夺的时间和联合使用水合氯醛与否,将纳入的受试者分为4组(第1组:睡眠剥夺时间≥2 h+0镇静;第2组:睡眠剥夺时间≥2 h+水合氯醛镇静;第3组:睡眠剥夺时间<2 h+0镇静;第4组:睡眠剥夺时间<2 h+水合氯醛镇静)。对ABR检查准备时间、检查持续时间、被中断或被迫停止的患儿进行分析。结果共纳入689例受试者,年龄3个月～11岁。440例(63.9%)单用睡眠剥夺获得自然睡眠,且检查成功率为95.5%(420/440)。第2组受试者检查成功率最高,为98.8%;最低为第4组,为90.4%。低于6个月龄的婴儿水合氯醛的使用率极低,仅为21.3%。结论短期睡眠剥夺是一种安全有效的提高ABR测试成功率的方法,并且可以极大程度减少水合氯醛在ABR检查中的用量。
Objective To evaluate the feasibility and efficacy of single sleep for ABR in children. Methods Medical and audiology records were reviewed of children who underwent ABR testing from 2012 to 2016. According to the deprived sleep time and sedation by CH, children were divided into four groups: group Ⅰ( deprivation time≥ 2 hours + no sedative), group Ⅱ(deprivation time ≥ 2 hours + sedative), group Ⅲ(deprivation time < 2 hours +no sedative), group Ⅳ(deprivation time < 2 hours + sedative). The time of preparing examination, duration of ABR and interrupted cases were reviewed. Results Totally 689 children aging 3 months to 11 years were included. 440 of 689 children(63.9%) obtained a spontaneous nap through single sleep deprivation with a success rate of 95.5%.The success rate of the examination was highest(98.8%) in group Ⅱ and the lowest(90.4%) in group Ⅳ. Only 21.3% of infants less than 6 months were administrated with CH. Conclusions Short-term sleep deprivation is a safe and effective method for children who receive auditory brainstem responses testing, and reduces the dose of chloral hydrate.
Objective To evaluate the feasibility and efficacy of single sleep for ABR in children. Methods Medical and audiology records were reviewed of children who underwent ABR testing from 2012 to 2016. According to the deprived sleep time and sedation by CH, children were divided into four groups: group Ⅰ( deprivation time≥ 2 hours + no sedative), group Ⅱ(deprivation time ≥ 2 hours + sedative), group Ⅲ(deprivation time < 2 hours +no sedative), group Ⅳ(deprivation time < 2 hours + sedative). The time of preparing examination, duration of ABR and interrupted cases were reviewed. Results Totally 689 children aging 3 months to 11 years were included. 440 of 689 children(63.9%) obtained a spontaneous nap through single sleep deprivation with a success rate of 95.5%.The success rate of the examination was highest(98.8%) in group Ⅱ and the lowest(90.4%) in group Ⅳ. Only 21.3% of infants less than 6 months were administrated with CH. Conclusions Short-term sleep deprivation is a safe and effective method for children who receive auditory brainstem responses testing, and reduces the dose of chloral hydrate.
引文
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[10]樊军,张勇.睡眠剥夺配合水合氯醛在婴幼儿肺功能检查中的镇静催眠效果观察[J].实用医院临床杂志,2013,10(3):96-97.
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[12]GAUILLARD J,CHEREF S,VACHERONTRYSTRAM M N,et al.Chloral hydrate:a hypnotic best forgotten[J].Encephale,2002,28(3 Pt 1):200-204.
[13]BASNER M,RAO H,GOEL N,et al.Sleep deprivation and neurobehavioral dynamics[J].Curr Opin Neurobiol,2013,23(5):854-863.
[14]DOCTOR K,ROBACK M G,TEACH S J.An update on pediatric hospital-based sedation[J].Curr Opin Pediatr,2013,25(3):310-316.
[15]HIJAZI O M,HAIDAR N A,AL-EISSA Y A.Chloral hydrate.An effective agent for sedation in children with age and weight dependent response[J].Saudi Med J,2005,26(5):746-749.
[2]MOLINI E,CRISTI M C,LAPENNA R,et al.Improving regional universal newborn hearing screening programmes in Italy[J].Acta Otorhinolaryngol Ital,2016,36(1):10-14.
[3]SALLY A W,GRAHAM J S,ADRIAN C D.Performance and characteristics of the newborn hearing screening programme in England:The first seven years[J].Int J Audiol,2015,54(6):353-358.
[4]IOANNIS P,CHARALAMPOS V,IOANNIS K,et al.Recovery of abnormal ABR in neonates and infants at risk of hearing loss[J].Int J Otolaryngol,2017,2017:7912127.
[5]MERDINK J L,ROBISON L M,STEVENS D K,et al.Kinetics of chloral hydrate and its metabolites in male human volunteers[J].Toxicology,2008,245(1/2):130-140.
[6]VALENZUELA D G,KUMAR D S,ATKINS C L,et al.Chloral hydrate sedation for auditory brainstem response(ABR)testing in children:safety and effectiveness[J].Int J Pediatr Otorhinolaryngol,2016(83):175-178.
[7]THOMAS D A,POOLE K,MCARDLE E K,et al.The effect of sleep deprivation on sleep states,breathing events,peripheral chemoresponsiveness and arousal propensity in healthy 3 month old infants[J].Eur Respir J,1996,9(5):932-938.
[8]OZTURK L,BULUT E,VARDAR S A,et al.Effects of sleep deprivation on anaerobic exercise-induced changes in auditory brainstem evoked potentials[J].Clin Physiol Funct Imaging,2007,27(5):263-267.
[9]陈霞,陈银,冉启英.睡眠剥夺在儿童MRI检查中的作用[J].第三军医大学学报,2014,36(11):1217-1219.
[10]樊军,张勇.睡眠剥夺配合水合氯醛在婴幼儿肺功能检查中的镇静催眠效果观察[J].实用医院临床杂志,2013,10(3):96-97.
[11]American Academy of Pediatrics Committee on Drugs and Committee on Environmental Health:Use of chloral hydrate for sedation in children[J].Pediatrics,1993,92(3):471-473.
[12]GAUILLARD J,CHEREF S,VACHERONTRYSTRAM M N,et al.Chloral hydrate:a hypnotic best forgotten[J].Encephale,2002,28(3 Pt 1):200-204.
[13]BASNER M,RAO H,GOEL N,et al.Sleep deprivation and neurobehavioral dynamics[J].Curr Opin Neurobiol,2013,23(5):854-863.
[14]DOCTOR K,ROBACK M G,TEACH S J.An update on pediatric hospital-based sedation[J].Curr Opin Pediatr,2013,25(3):310-316.
[15]HIJAZI O M,HAIDAR N A,AL-EISSA Y A.Chloral hydrate.An effective agent for sedation in children with age and weight dependent response[J].Saudi Med J,2005,26(5):746-749.