摘要
目的分析右美托咪定与咪达唑仑对重症加强治疗病房(intensive care unit,ICU)机械通气集束化治疗患者的镇静效果。方法选择本院ICU于2017年1月-2018年10月收治的86例接受机械通气集束化治疗的危重症患者作为研究对象,按照随机数表法分为两组,观察组43例,给予右美托咪定镇静,对照组43例,给予咪达唑仑镇静,比较两组患者的镇静镇痛效果、治疗时的血流动力学指标变化情况及不良反应。结果观察组机械通气时间、药物起效时间、停药后至完全清醒时间、拔管时间、ICU入住时间、平均RASS评分均显著低于对照组,差异有统计学意义(P<0.05);用药后1 h(T1)、用药后2 h(T2)、用药后3 h(T3)MAP、HR均显著降低,差异有统计学意义(P<0.05);观察组T1、T2、T3时刻MAP、HR均显著低于对照组,差异有统计学意义(P<0.05);观察组低血压、谵妄、心动过速、心律失常发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论对ICU机械通气集束化治疗患者采用右美托咪定进行镇静治疗,镇静效果更佳,不良反应更少,时效性与安全性更高。
Objective To analyze the sedative efect of dexmedetomidine and midazolam on mechanical ventilation cluster therapy in intensive care unit(ICU).Methods 86 critically ill patients who underwent mechanical ventilation clustering treatment from January 2017 to October 2018 in the hospital were selected as subjects.They were divided into two groups according to the random number table method,and 43 patients in the observation group were given dexmedetomidine,and 43 patients in the control group were given midazolam.The sedative analgesic effect,hemodynamic index changes and adverse reactions during treatment were compared between the two groups of patients.Results The mechanical ventilation time,drug onset time,total awake time after drug withdrawal,tube extubation time,ICU stay time and average RASS score in the observation group were signifcantly lower than those in the control group,the diference was statistically signifcant(P<0.05).MAP and HR were signifcantly decreased at 1 h(T1),2 h(T2)and 3 h(T3)after administration,the diference was statistically signifcant(P<0.05).MAP and HR at T1,T2 and T3 in the observation group were signifcantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of hypotension,delirium,tachycardia and arrhythmia in the observation group was signifcantly lower than that in the control group,the diference was statistically signifcant(P<0.05).Conclusion For patients with ICU mechanical ventilation cluster therapy,dexmedetomidine was used for sedation with better sedation efect,fewer adverse reactions,higher timeliness and safety.
作者
耿恒
徐凡
GENG Heng;XU Fan(Department of Intensive Care Unit,Jingzhou First People's Hospital,Jingzhou Hubei 434000,China)
出处
《中国继续医学教育》
2019年第22期103-106,共4页
China Continuing Medical Education
