摘要
目的 评估芬太尼联合咪达唑仑镇痛镇静在神经外科重症患者行改良经皮气管切开术中的应用效果.方法 收集2018年6月~2019年9月河北北方学院附属第一医院71例实施改良经皮气管切开手术患者的临床资料,根据使用的镇痛镇静药物不同分为两组,观察组(n=36)给予芬太尼联合咪达唑仑,对照组(n=35)给予地西泮或冬眠合剂.比较两组操作时间、术中血氧饱和度、气道刺激反应、术中出血量、术后渗血量.结果 两组操作时间比较,差异无统计学意义(P>0.05).两组患者术中渗血及术后渗血情况比较,差异无统计学意义(P>0.05).观察组气道刺激反应小于对照组,差异有统计学意义(P<0.01).观察组患者操作期间血氧饱和度大于对照组,差异有统计学意义(P<0.01).两组均无手术相关死亡及气胸病例.结论 芬太尼联合咪达唑仑镇痛镇静可显著减轻经皮气管切开术中的气道刺激反应,维持操作期间血氧饱和度的稳定,可提高手术安全性.
Objective To evaluate the application effect of sedation and analgesia with Fentanyl and Midazolam in modified percutaneous tracheostomy for severe patients in neurosurgery.Methods Clinical data of 71 patients whom underwent modified percutaneous tracheostomy in the First Affiliated Hospital of Hebei North University were collected from June 2018 to September 2019.They were divided into two groups according to the drugs for sedation and analgesia randomly,Fentanyl and Midazolam were used in the observation group(n=36)and Diazepam or lytic cocktail were used in the control group(n=35).The operation time,blood oxygen saturation,tracheal stimulus response,intraoperative and postoperative bleeding volume were compared between the two groups.Results There was no statistically significance in operation time of two groups(P>0.05).There were no significant differences in intraoperative and postoperative bleeding volume of the two groups(P>0.05).Tracheal stimulus response of observation group was weaker than control group,the difference was statistically significant(P<0.01).Blood oxygen saturation in observation group was higher than that in control group,the difference was statistically significant(P<0.01).No operation related death or pneumothorax case in two groups.Conclusion Sedative and analgesic therapy with Fentanyl and Midazolam can reduce tracheal stimulus response and maintain a stable blood oxygen saturation in modified percutaneous tracheostomy effectively,and it is a safer procedure.
作者
杜秀玉
翟晓东
刘志
李媛莉
杨静
孙志强
杨晓洪
高飞
DU Xiuyu;ZHAI Xiaodong;LIU Zhi;LI Yuanli;YANG Jing;SUN Zhiqiang;YANG Xiaohong;GAO Fei(Department of Neurosurgery(Ward 15),the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Intensive Care Unit,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Emergency Intensive Care Unit,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China)
出处
《中国医药导报》
CAS
2020年第16期109-111,138,共4页
China Medical Herald
基金
河北省技术创新引导计划项目(科技冬奥专项)(19977797D)。
关键词
镇静镇痛
经皮气管切开
血氧饱和度
Sedation and analgesia
Percutaneous tracheostomy
Blood oxygen saturation
