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肿瘤患者的骨髓穿刺:来自儿科内部标准的经验。

Bone marrow aspirations in oncological patients: experience from an in-house standard in paediatrics.

作者信息

Sauer Harald, Graeber Stefan, Lieser Ulla, Foell Juergen

机构信息

Clinic for Pediatric Cardiology, University Hospital of Saarland, 66421, Homburg, Germany.

Institute of Medical Biometry, Epidemiology and Medical Computer Science, University Hospital of Saarland, Kirrberger Straße, Homburg (Saar), Germany.

出版信息

Wien Med Wochenschr. 2019 Mar;169(3-4):82-86. doi: 10.1007/s10354-017-0611-1. Epub 2017 Dec 1.

DOI:10.1007/s10354-017-0611-1
PMID:29196827
Abstract

BACKGROUND

Nearly all paediatric patients require deep sedation when undergoing bone marrow aspiration (BMA). We analyzed the data from our protocols documented in a standardised procedure for bone marrow puncture over a period of 2 years.

METHODS

Our standard included the documentation of personal data as well as vital parameters. In addition, we documented all medications administered, potential complications and required intervention measures, as necessary.

RESULTS

A total of 107 protocols were available for the evaluation. Our standard covered the usage of midazolam and S‑ketamine and resulted in complications in just 9 patients, which could be remedied using simple measures. For both active substances, the dosage necessary to reach sufficient deep analgosedation was significantly higher for patients under 24 months of age.

CONCLUSIONS

Our standard for BMA provides a practical and feasible procedure. In addition to good examination conditions, our standard also helps ensure the safety of our patients.

摘要

背景

几乎所有儿科患者在进行骨髓穿刺术(BMA)时都需要深度镇静。我们分析了在两年时间里按照标准化骨髓穿刺程序记录的方案数据。

方法

我们的标准包括记录个人数据以及生命体征参数。此外•我们还记录了所有给予的药物、潜在并发症以及必要时所需的干预措施。

结果

共有107份方案可供评估。我们的标准涵盖了咪达唑仑和S-氯胺酮的使用,仅9例患者出现并发症,可通过简单措施补救。对于这两种活性物质,24个月以下的患者达到足够深度镇痛镇静所需的剂量明显更高。

结论

我们的BMA标准提供了一个切实可行的程序。除了良好的检查条件外,我们的标准还有助于确保患者的安全。

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Anxiety and pain during bone marrow aspiration and biopsy.骨髓穿刺和活检过程中的焦虑与疼痛。
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Sedation and analgosedation performed by pediatricians--experience made with the implementation of an in-house sedation standard: Sedation and analgosedation-implemantation of an in-house standard.儿科医生实施的镇静和镇痛镇静——内部镇静标准实施经验:镇静和镇痛镇静——内部标准的实施。
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Pain and anxiety during bone marrow aspiration/biopsy: Comparison of ratings among patients versus health-care professionals.骨髓抽吸/活检时的疼痛和焦虑:患者与医护人员评分比较。
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Ketamine/propofol versus midazolam/fentanyl for procedural sedation and analgesia in the emergency department: a randomized, prospective, double-blind trial.氯胺酮/异丙酚与咪达唑仑/芬太尼在急诊科镇静和镇痛中的应用:一项随机、前瞻性、双盲试验。
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Professional skills and competence for safe and effective procedural sedation in children: recommendations based on a systematic review of the literature.儿童安全有效程序性镇静的专业技能与能力:基于文献系统评价的建议
Int J Pediatr. 2010;2010:934298. doi: 10.1155/2010/934298. Epub 2010 Jun 28.
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Use of ketofol for procedural sedation and analgesia in children with hematological diseases.酮咯酸氨丁三醇用于血液系统疾病患儿的程序性镇静和镇痛。
Pediatr Int. 2011 Feb;53(1):62-7. doi: 10.1111/j.1442-200X.2010.03200.x.
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A prospective case series of pediatric procedural sedation and analgesia in the emergency department using single-syringe ketamine-propofol combination (ketofol).一项在急诊科使用单注射器氯胺酮-丙泊酚组合(氯胺酮)进行小儿程序镇静和镇痛的前瞻性病例系列研究。
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