右美托咪定与咪达唑仑镇静在机械通气患者中的应用

发布时间：2018-01-25 04:47

本文关键词： 右美托咪定机械通气炎症因子　出处：《临床麻醉学杂志》2016年07期 　论文类型：期刊论文

【摘要】：目的观察右美托咪定与咪达唑仑在机械通气患者中的应用。方法将2014年5月至2015年1月我院ICU病房收治的76例需要有创机械通气及持续镇静治疗的患者,按照随机数字表法均分为咪达唑仑组(M组)和右美托咪定组(D组)。M组:咪达唑仑负荷量0.06 mg/kg静注,维持量0.04~0.2mg·kg-1·h-1;D组,右美托咪定负荷量1μg/kg静注10min,维持量0.2~0.7μg·kg-1·h-1。根据Ramsay镇静评分调整药物用量,使Ramsay镇静评分维持在2~4分。记录两组患者用药后达到Ramsay镇静评分2~4分的时间、Ramsay镇静评分、ICU住院时间、机械通气时间、唤醒时间。同时采用酶联免疫吸附法(ELISA)检测两组患者用药前、用药后24、48h血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)水平的变化。结果 D组患者的ICU住院时间和唤醒时间明显短于M组(P0.05)。用药后24hD组患者血清TNF-α、hs-CRP水平明显低于M组(P0.05),两组血清IL-6水平差异无统计学意义;用药后48hD组血清hsCRP水平明显低于M组(P0.05),两组患者血清TNF-α、IL-6水平差异无统计学意义。结论有创性机械通气患者使用右美托咪定镇静,缩短患者ICU住院时间,且能有效降低患者体内炎症因子水平。
[Abstract]:Objective to observe the application of dexmetomidine and midazolam in patients with mechanical ventilation. Methods 76 cases of ICU patients who needed invasive mechanical ventilation and sustained sedation from May 2014 to January 2015 were treated in our hospital. The patient who was treated. According to the random number table method, they were divided into midazolam group (M group) and dexmetoimidine group (group D): midazolam loading dose was 0.06 mg/kg intravenous injection. The maintenance dose was 0.04 ~ 0.2mg 路kg-1 路h-1; In group D, the dosage of dexmetidine was adjusted according to Ramsay sedative score by intravenous injection of 1 渭 g / kg for 10 minutes and maintenance of 0.2 渭 g 路kg-1 路h-1.The dose of dexmetidine was adjusted according to Ramsay sedative score. The Ramsay sedation score was maintained at 2 ~ 4 points. The time of Ramsay sedation score 2 ~ 4 was recorded. Mechanical ventilation time, wake-up time and Elisa were used to detect serum TNF- 伪 before and after 24 hours of administration. Interleukin-6 (IL-6). Results the hospitalization time and wake-up time of ICU in group D were significantly shorter than those in group M (P 0.05). Serum TNF- 伪 was found in group D 24 h after treatment. The level of hs-CRP was significantly lower than that of group M (P 0.05). There was no significant difference in serum IL-6 between the two groups. The level of serum hsCRP in group D was significantly lower than that in group M (P0.05A) 48 hours after treatment. The serum levels of TNF- 伪 in group D were significantly lower than those in group M (P 0.05). Conclusion the use of dexmetomidine in patients with invasive mechanical ventilation can shorten the hospitalization time of patients with ICU and can effectively reduce the level of inflammatory factors in the patients.
【作者单位】：重庆市人民医院ICU;
【分类号】：R614
【正文快照】： 呼吸衰竭是重症监护室的常见疾病或并发症,常常需要机械通气作为辅助治疗手段,给予患者镇静药物是机械通气过程中的重要环节,但临床上如何选择合适的镇静药物关系到患者能否顺利撤机甚至预后[1]。本研究通过比较咪达唑仑与右美托咪定两种药物对ICU需机械通气患者的影响,以期对

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