右美托咪定对重症监护病房机械通气患者的临床疗效  

Clinical effcet of dexmedetomidine in mechanically ventilated patients in intensive care unit

作　　者：田勇刚[1] 乔鲁军[1] 宋秀梅[2] 

机构地区：[1]东营胜利油田中心医院重症医学科,山东东营257000 [2]山东省千佛山医院麻醉科,济南250000

出　　处：《中国临床药理学杂志》2015年第21期2096-2098,共3页The Chinese Journal of Clinical Pharmacology

基　　金：2014年度山东省医药卫生科技计划基金资助项目(2014ZRB14188)

摘　　要：目的探讨右美托咪定和脑电双频指数用于重症监护病房(ICU)机械通气患者的镇静作用。方法手术后需气管插管机械通气的ICU患者58例,随机分为试验组和对照组,各29例。试验组静脉注射右美托咪定0.5μg·kg-1,并以0.2μg·kg-1·h-1的速度静脉泵注。对照组静脉泵注咪达唑仑负荷剂量0.06 mg·kg-1,以0.4 mg·kg-1·h-1的速度维持镇静。记录不同时间2组患者的平均动脉压(MAP),呼吸频率(RR),脉搏血氧饱和度(Sp O2),心率(HR),Ramsay评分,脑电双频指数(BIS)值,脱机时间,不良反应发生情况。结果镇静前各时间点MAP、呼吸频率、心率和Sp O2差异无统计学意义(P>0.05);镇静后呼吸频率和心率下降明显,与镇静前比较差异有统计学意义(P<0.05)。与镇静前比较,镇静后各时间点BIS值显著下降,Ramsay评分显著升高(P<0.05)。试验组镇静后各时间点BIS值和Ramsay评分与对照组比较差异无统计学意义(P>0.05)。试验组患者谵妄、心动过缓和低血压发生率显著低于对照组(P<0.05),试验组的入ICU至开始脱机时间显著短于对照组(P<0.05)。结论右美托咪定在ICU机械通气患者术后的镇静具有良好的效果,不良反应和术后并发症更少。Objective To explore the sedation effect of dexmedetomi-dine and bispectral index for the treatment of intensive care unit（ ICU） patients with mechanical ventilation.Methods A total of 58 postopera-tion ICU patients needing mechanical ventilation were randomized into treatment group and control group. Treatment group was intravenous injected dexmedetomidine 0.5 μg· kg-1 , and 0.2 μg· kg -1· h-1 in-travenous infusion.Control group was intravenous infusion loading dose of midazolam 0.06 mg· kg -1 , intravenous infusion 0.4 mg· kg-1· h-1 to maintain sedation.The arterial pressure （ MAP） , respiratory rate （ RR） , pulmonary cardiac blood oxygen saturation （ SpO2 ） , heart rate （ HR ） , Ramsay score, bispectral index （ BIS） , adverse reactions and complica-tions at different times were monitored.Results MAP, RR, HR and SpO2 at each time were no difference after sedation （ P〉0.05）.RR and HR decreased obviously compared with before sedation （ P〈0.05）. Compared with before sedation, BIS value significantly decreased, Ram-say score was significantly higher （ P〈0.05 ） .After sedation, the BIS value and Ramsay score had no difference between the two groups （P〉0.05）.Delirium,beckoning too moderate and hypotension incidence in treatment group were lower those of con-trol group （ P〈0.05 ） , duration from ICU arrival to off time and diastasis were significantly shorter than that of control group（ P 〈0.05 ） .Conclusion Dexmedetomidine has good sedation effect for patients with mechanical ventilation with reduced adverse reactions and complications.

关 键 词：右美托咪定 脑电双频指数 镇静 

分 类 号：R619[医药卫生—外科学] R971.1[医药卫生—临床医学]