盐酸右美托咪定用于机械通气的COPD患者镇静的临床观察  

Clinical observation of dexmedetomidine in the sedation of COPD patients treated with mechanical ventilated

作　　者：肖涛[1] 罗宇鸿[1] 吴锡平[1] 王倩[1] 孙月雯[1] 

机构地区：[1]无锡市中医医院ICU,江苏无锡214001

出　　处：《临床肺科杂志》2013年第10期1817-1818,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨以盐酸右美托咪定对重症监护病房(ICU)的机械通气的COPD患者镇静效果的影响。方法 32例COPD患者随机分为咪达唑仑组(对照组)和盐酸右美托咪定组(实验组),每组16例。记录镇静前的APACHEⅡ评分、Ramsay评分,记录镇静开始、2 h、6 h和12 h中的收缩压(SBP)、舒张压(DBP)、脉搏(HR)、呼吸(RP)、脉搏氧饱和度(SpO2)、气道峰压(Paw)、氧合指数(PaO2/FiO2)。镇静达12 h时停止药物输注,每10 min评估1次镇静深度,记录恢复时间,达到满意镇静深度的时间,镇静满意程度。结果使用盐酸右美托咪定能达到满意的镇静效果,比较咪达唑仑组,镇静满意时间和恢复时间,实验组均明显少于对照组(P<0.05);实验组的镇静满意程度明显高于对照组(P<0.05)。结论右美托咪定镇静效果满意,可使患者随时可唤醒状态,且无呼吸抑制,安全性高。Objective To explore the sedative effect of dexmedetomidine as a ward-based sedation on mechanical ventilated COPD patients in intensive care unit. Methods 32 COPD patients were randomly and evenly divided into two groups. The control group was treated with midazolam, and the experiment group was treated with dexmedetomidine. APACHE lI score and Ramsay score were re- corded, and the values of SBP, DBP, HR, RP, SpO2, Paw and PaO2/FiO2 were detected at 0 h, 2 h, 6 h and 12 h after sedation. The infusion was ceased 12 hours after sedation, and then the sedative degree was assessed every 10 minutes. Recover time to achieve satisfac- tory sedation and the sedation level were recorded. Results The experiment group could achieve satisfactory sedation, and the time to a- chieve satisfactory sedation and recovery was obviously shorter in the experiment group than in the control group （ P 〈 0. 05 ）. The satisfac- tory degree of sedation was significantly higher in the experiment group than in the control group （ P 〈0. 05 ）. Conclusion Dexmedetomi- dine has higher satisfactory sedation level and shorter awakening time without respiratory depression in the treatment of COPD patients.

关 键 词：盐酸右美托咪定 COPD 机械通气 镇静 

分 类 号：R563.9[医药卫生—呼吸系统]