摘要
目的探讨舒芬太尼联合咪达唑仑对颅脑损伤患者的镇静镇痛效果及安全性。方法选取2015年7月—2016年12月重症监护室收治的颅脑损伤患者43例,根据镇静镇痛方案不同分为观察组21例和对照组22例。对照组应用咪达唑仑联合吗啡,观察组应用舒芬太尼联合咪达唑仑。比较两组的镇静镇痛效果、免疫指标变化情况及不良反应。结果观察组治疗后12 h、24 h、36 h、72 h时Ramsay评分均低于对照组(P<0.001)。治疗后24 h、36 h、72 h时,观察组Ramsay评分低于治疗后12 h,对照组高于治疗后12 h(P<0.05)。两组治疗后24 h和72 h的CD4+、CD8+和CD4+/CD8+水平较治疗前明显上升(P<0.05),IL-10水平较治疗前明显下降(P<0.05)。治疗后24 h和72 h,两组CD4+、CD8+和IL-10水平比较均存在明显差异(P<0.05);治疗后72 h,两组CD4+/CD8+水平比较存在明显差异(P<0.05)。两组镇痛前后CPOT疼痛评分和不良反应总发生率比较差异无统计学意义(P>0.05)。结论舒芬太尼联合咪达唑仑对颅脑损伤患者的镇静镇痛效果佳,可改善患者免疫功能,且安全性高。
Objective To investigate sedative analgesic effect and safety of Sufentanil combined with Midazolam in treatment of patients with craniocerebral injury.Methods A total of 43 patients with craniocerebral injury admitted during July 2015 and December 2016 were divided into observation group(n=21)and control group(n=22)according to sedative analgesic methods.Control group was treated with Midazolam combined with Morphine,while observation group was treated with Sufentanil combined with Midazolam.Sedative analgesic effect,changes of immune indicators and incidence rate of adverse reactions were compared in two groups.Results Ramsay scores in 12 h,24 h,36 h and 72 h after treatment in observation group were significantly lower than those in control group(P<0.001).In 24 h,36 h and 72 h after treatment,Ramsay scores were significantly lower than that in 12 h after treatment in observation group,while the scores were significantly higher than that in 12 h after treatment in control group(P<0.05).In two groups,levels of CD4+,CD8+and CD4+/CD8+in 24 h and 72 h were significantly higher(P<0.05),while IL-10 levels were significantly lower than those before treatment(P<0.05).In 24 h and 72 h after treatment,there were significant differences in CD4+,CD8+and IL-10 levels between two groups(P<0.05).In 72 h after treatment,there was a significant difference in CD4+/CD8+level between two groups(P<0.05).There were no significant differences in CPOT pain scores and the total incidence rate of adverse reactions before and after analgesia between two groups(P>0.05).Conclusion Sufentanil combined with Midazolam may achieve good sedative analgesia effect and improve immune function with good safety in patients with craniocerebral injury.
作者
肖骏
李德科
XIAO Jun;LI De-ke(Department of Anesthesiology,the Fifth Hospital of Wuhan,Wuhan 430050,China)
出处
《解放军医药杂志》
CAS
2018年第3期66-69,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
武汉市科学技术局基金项目(WX15D27)
关键词
舒芬太尼
咪达唑仑
颅脑损伤
镇痛
Sufentanil
Midazolam
Craniocerebral trauma
Analgesia
