咪唑安定序贯盐酸右美托咪定对ICU机械通气患者镇静的临床研究

发布时间：2018-07-15 20:53

【摘要】：目的研究咪唑安定序贯盐酸右美托咪定用于重症加强护理病房(ICU)机械通气患者镇静的临床效果。方法将河北医科大学第四医院150例ICU机械通气患者抽签随机分为A~C 3组,每组50例。A组:咪唑安定+盐酸右美托咪定疗程序贯镇静,B组:咪唑安定+盐酸右美托咪定每日序贯镇静,C组单纯咪唑安定镇静,3组均配合舒芬太尼基础镇痛,以Riker镇静和躁动评分系统(SAS)指导镇静深度,以危重症疼痛观察工具(CPOT)监测镇痛效果,比较3组恢复性指标差异及舒芬太尼用量,观察3组镇静、唤醒过程中不良事件(低血压、心动过缓、谵妄)发生率及临床转归(ICU死亡、院内死亡)。结果 3组机械通气时间与每日唤醒时间呈ABC的递增趋势,两两比较差异有统计学意义(P0.05),A、B两组ICU停留时间、住院时间、舒芬太尼用量及ICU花费组间比较差异无统计学意义(P0.05),但A、B两组均低于C组;3组镇静、唤醒过程低血压、心动过缓、谵妄发生率比较差异无统计学意义(P0.05),C组低血压、谵妄发生率稍高于A、B组,B组谵妄稍高于A组;3组ICU死亡及院内死亡发生率比较差异无统计学意义(P0.05)。结论咪唑安定序贯盐酸右美托咪定用于ICU机械通气患者可缩短机械通气时间,降低ICU总花费,缩短每日唤醒时间,并可降低镇痛药用量,未见明显严重不良反应发生,其中疗程序贯镇静方式具有更高的安全性。
[Abstract]:Objective to study the sedation effect of midazolam sequential dexmetomidine hydrochloride in mechanical ventilation patients in intensive care unit (ICU). Methods 150 ICU mechanical ventilation patients in the fourth Hospital of Hebei Medical University were randomly divided into three groups. Group A (n = 50): midazolam hydrochloride, dexmetidine hydrochloride, sedation group B: midazolam hydrochloride, dexmetomidine hydrochloride, daily sequential sedation group C, simple midazolam sedation combined with basic sufentanil analgesia. The sedation depth was guided by the Riker sedative and restlessness score system (SAS), the analgesic effect was monitored with critical pain observation tool (CPOT), the difference of recovery indexes and the dosage of sufentanil were compared among the three groups, and the adverse events (hypotension) during sedation and arousal were observed. Incidence of bradycardia, delirium and clinical outcome (ICU death, hospital death). Results the mechanical ventilation time and the daily wake-up time of the three groups showed an increasing trend of ABC, the difference was statistically significant (P0.05) the ICU stay time and hospitalization time of the two groups were significantly different. There was no significant difference in sufentanil dosage and ICU expenditure between the two groups (P0.05), but the incidence of hypotension, bradycardia, delirium and hypotension in group A and B were lower than those in group C (P0.05). The incidence of delirium was a little higher in group A than in group B and group B was higher than that in group A and group A, and there was no significant difference in the incidence of death and hospital death between group A and group A (P0.05). Conclusion Mizolam sequential dexmetomidine hydrochloride can shorten the time of mechanical ventilation, reduce the total cost of ICU, shorten the daily arousal time, and reduce the dosage of analgesics. Among them, the sedative procedure has higher safety.
【作者单位】：河北医科大学第四医院急诊科;河北医科大学第四医院重症医学科;
【分类号】：R459.7

【相似文献】