摘要
目的探讨咪达唑仑联合瑞芬太尼控制成人破伤风患者痉挛的效果。方法选取2012年7月~2015年11月第三军医大学大坪医院收治的22例成人破伤风患者,采用经中心静脉通路持续微量泵入咪达唑仑与瑞芬太尼复合镇静、镇痛治疗,观察患者用药前后的生命体征变化,痉挛发作次数及持续时间、Ramsay镇静评分、张口大小等指标。结果所有患者使用药物时间平均(13.5±3.2)d;Ramsay镇静评分平均(3.2±1.3)分;用药前后比较,痉挛发作频次明显减少,持续时间明显缩短,张口逐渐增大(P<0.05);用药后血压下降,心率明显减慢(P<0.05);呼吸及中心静脉压(CVP)在用药前后变化不明显(P>0.05);22例患者全部治愈出院,无死亡及并发症发生。结论在严格监护下,咪达唑仑联合瑞芬太尼持续静脉泵入,为破伤风患者痉挛的控制提供了一种新型安全、切实有效的治疗手段,能达到理想的镇静、镇痛及控制痉挛效果。
Objective To investigate the effect of midazolam combined with remifentanil on the control of spasm in adult patients with tetanus. Methods Twenty-two adult patients with tetanus （mild, moderate, severe） were studied from Jul. 2012 to Nov. 2015. These patients were treated by continuous micro pump infusion of midazolam combined with remifentanil for sedation and analgesia. The changes of vital signs, the frequency and duration of spasm, the Ramsay sedation score and the size of mouth opening were observed before and after treatment. Re- suits All the patients had an average medication of （ 13.5 ± 3.2 ） d and mean Ramsay sedation score of （ 3.2±1.3 ） points. Compared with before treatment, the seizure frequency was significantly reduced, the duration was significantly shorter, and the mouth opening increased gradually after medication （ P 〉 0. 05）. Blood pressure and heart rate were significantly decreased （ P 〈 0. 05 ）. Respiratory and CVP changes were not significant before and after treatment（P 〉0. 05）. All patients were cured. There was no severe complication or death in this study. Conclusion Continuous intravenous infusion of midazolam combined with remifentanil under strict monitoring provides a safe and effective method in the treatment of tetanus patients. This treatment can achieve better sedation and analgesia and can control spasm effect.
出处
《创伤外科杂志》
2017年第6期466-468,共3页
Journal of Traumatic Surgery
