四种镇静药物对急性有机磷中毒机械通气患者的疗效和安全性对比研究  

The efficacy and safety of four kinds of sedative drugs in patients with acute organophosphorus poisoning undergoing mechanical ventilation

作　　者：于中锴[1] 孙宝泉[1] 姜学青[1] 赵波[1] 刘乃政[1] 杨静杰[1] 陈士超[1] 

机构地区：[1]山东省聊城市人民医院急诊科,山东聊城252000

出　　处：《创伤与急诊电子杂志》2015年第2期17-19,23,共4页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的比较常用四种镇静药物对急性有机磷中毒机械通气患者的疗效和安全性,为临床合理用药提供循证依据。方法选取急性有机磷中毒机械通气患者84例随机平均分成4组,分别按药品说明书和相关专业指南给予静脉泵入地西泮、咪达唑仑、丙泊酚、右美托咪定镇静。按Ramsay分级法评估镇静效果;密切监测生命体征及各项生化指标。结果镇静后4组患者的心率、呼吸频率及平均动脉压都出现降低的情况,且与镇静前相比有统计学差异(P<0.05),但无论是镇静前还是镇静后,4组患者各项指标的组间比较均无统计学差异(P>0.05);右美托咪定组患者的不良反应发生率最低(P<0.05)。结论四种药物均能有效达到急性有机磷中毒机械通气的镇静要求;右美托咪定的安全性明显优于其他药物,但各药发生的不同程度的不良反应,经停药并积极处理后均能很快恢复。Objective To compare the efficacy and safety of four kinds of sedative drugs in patients with acute organophosphorus poisoning undergoing mechanical ventilation and provide evidence for the rational use of drugs.Method Selected patients （84 cases） were randomly divided into four groups and given intravenous infusion of diazepam, midazolam, propofol and dexmedetomidine. Sedative effect was evaluated according to Ramsay＆#39;s classification evaluation and vital signs and biochemical indexes were monitored and recorded at the same time. Result Heart rate（HR）, respiratory frequency（RR） and mean arterial pressure （MAP） except for pulse oxygen saturation in four groups after treatment significantly decrease, compared with the data before treatment （〈0.05, respectively）. Whether before or after treatment, there were no statistically significant differences in these indexes among the four groups （P〉0.05, respectively）. The incidence of the adverse effects of patients treated by dexmedetomidine was the lowest （P〈0.05,respectively）.Conclusion Four drugs are effective in maintaining sedation of patients with acute organophosphorus poisoning undergoing mechanical ventilation. Dexmedetomidine is superior to other drugs in safety, but different adverse effects of each drug will disappear soon by drug withdrawal and active treatment.

关 键 词：镇静 有机磷中毒 机械通气 安全性 有效性 

分 类 号：R595.4[医药卫生—内科学]