右美托咪定对AECOPD并机械通气患者镇静效果的临床观察

发布时间：2018-05-01 15:22

本文选题：右美托咪定 + 慢性阻塞性肺疾病急性加重期　；参考：《重庆医学》2017年18期

【摘要】：目的探讨右美托咪定对慢性阻塞性肺疾病急性加重期(AECOPD)并机械通气患者镇静治疗的有效性及安全性。方法选择2014年7月至2015年12月该院重症医学科收治的AECOPD并需要机械通气治疗的患者48例;将患者分为观察组(右美托咪定治疗)和对照组(咪达唑仑治疗),每组24例。记录两组患者镇静开始时和2h后的心率、平均动脉压(MAP)、呼吸频率、气道峰压(Paw)、动脉血氧饱和度(SaO_2)的变化;比较两组患者在镇静治疗过程中芬太尼用量、停止镇静治疗后唤醒时间、机械通气时间和ICU住院时间,以及两组患者的心血管不良事件发生率。结果两组分别使用右美托咪啶与咪达唑仑均能达到满意的镇静效果。与对照组比较,观察组芬太尼用量明显减少(P0.05),停药后唤醒时间短,可明显减少机械通气时间及ICU住院时间(P0.05)。两组患者用药期间心血管不良事件发生率比较,差异无统计学意义(P0.05)。结论右美托咪定用于AECOPD并机械通气患者的镇静治疗效果满意,治疗过程中易唤醒、无呼吸抑制,可缩短拔管时间、改善预后,是较理想的镇静剂。
[Abstract]:Objective to investigate the efficacy and safety of dexmetomidine in sedation treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and mechanical ventilation. Methods from July 2014 to December 2015, 48 patients with AECOPD who needed mechanical ventilation were selected and divided into observation group (dexmetomidine treatment) and control group (midazolam treatment group, 24 cases). The changes of heart rate (HR), mean arterial pressure (MAPP), respiratory frequency, peak airway pressure (Pawn) and arterial oxygen saturation (SaO2) were recorded at the beginning of sedation and 2 hours after sedation, and the dosage of fentanyl during sedation was compared between the two groups. Wake-up time, mechanical ventilation time and ICU hospitalization time after cessation of sedation, and the incidence of cardiovascular adverse events in both groups. Results the sedative effects of dexmetidine and midazolam were satisfactory in both groups. Compared with the control group, the dosage of fentanyl in the observation group was significantly reduced (P 0.05), the wake-up time was shorter, and the mechanical ventilation time and the ICU hospitalization time were significantly decreased in the observation group. There was no significant difference in the incidence of cardiovascular adverse events between the two groups (P 0.05). Conclusion the sedation effect of dexmetomidine in patients with AECOPD combined with mechanical ventilation is satisfactory. It is easy to wake up without respiratory inhibition and can shorten the extubation time and improve the prognosis. It is an ideal sedative.
【作者单位】：华中科技大学同济医学院附属武汉中心医院重症医学科;
【分类号】：R614

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