右旋美托咪定和丙泊酚治疗心脏术后谵妄的临床效果对比观察  

Observation of the clinical effect comparison between dexmedetomidine and propofol treated on patients with delirium after cardiac surgery

作　　者：李政玲[1,2] 陈桂霞[2] 张显平[3] 赵文静[3] 

机构地区：[1]徐州医学院护理学院,徐州221004 [2]滕州市中心人民医院 [3]徐州医学院附属医院

出　　处：《国际精神病学杂志》2016年第5期882-884,888,共4页Journal Of International Psychiatry

摘　　要：目的探讨比较右旋美托咪定和丙泊酚治疗心脏术后患者谵妄的临床效果及安全性。方法选择开展心脏手术的150例患者,按随机数字表法分为右旋美托咪定组(72例)和丙泊酚组(68例),比较两组在ICU住院天数、谵妄发生率、不良事件发生率等的差异。结果两组应用右旋美托咪定与丙泊酚治疗后的重症监护谵妄筛查量表(ICDSC)评分均较治疗前显著下降(P<0.05);治疗后右旋美托咪定组的ICDSC评分较丙泊酚组下降更为明显(P<0.05)。右旋美托咪定组治疗后7天内谵妄发生率为11.11%,住院天数平均为9.35天,分别低于丙泊酚组的16.18%和12.41天,差异均有统计学意义(P<0.05)。右旋美托咪定组的低血压(30.56%)、心动过缓(16.67%)、气管插管(4.17%)发生率均低于丙泊酚组,差异有统计学意义(P<0.05)。结论右旋美托咪定较丙泊酚治疗心脏术后谵妄疗效更确切,且在减少副作用方面,右旋美托咪定具有明显优势。Objective To observe the clinical effect on patients with delirium after cardiac surgery. Methods comparison between dexmedetomidine and propofol treated 150 patients undergoing cardiac surgery who were selected and randomly devided into the dexmedetomidine midazolam group （72 cases） and the propofol group （68 cases）. The ICU stays, delirium rates, adverse events ratedifferences between the two groups were compared. Results Intensive Care Delirium Screening Checklist （ICDSC） scores of the two groups all significantly decreased compared with those before treatment （P 〈 0.05）; ICDSC scores of the dexmedetomidine midazolam group were significantly lower than those of the propofol group （P〈0.05）. The incidence of delirium of the dexmedetomidine group was 11.11% and the ICU stays was 9.35 days ,which were significantly lower than those of the propofol group ,which were 16.18% and 12.41 days（P 〈 0.05）. Hypotension （30.56%）, tachycardia slow （16.67%）, tracheal intubation （4.17%） incidence rate of the dexmedetomidine midazolam group were significantly lower than those of the propofol group with significant difference （P〈0.05）. Conclusion Dexmedetomidine can be more effective to treat patients with delirium after cardiac surgery than propofol . Dexmedetomidine has significantly advantages in reducing side effects.Thus, it＇ s worthy of recommendation for clinical practice.

关 键 词：右旋美托咪定 丙泊酚 谵妄 

分 类 号：R749.2[医药卫生—神经病学与精神病学]