右美托咪定与咪达唑仑镇静辅助治疗急性期主动脉夹层的效果比较  

Auxiliary Effect of dexmedetomidine and midazolam on patients with acute aortic dissection

作　　者：杨吉军[1] 谢礼[1] 桂培根[1] 王德明[2] 

机构地区：[1]南华大学附属第二医院重症医学科,湖南省衡阳市421001 [2]南华大学附属第二医院麻醉科,湖南省衡阳市421001

出　　处：《实用医学杂志》2016年第24期4105-4107,共3页The Journal of Practical Medicine

基　　金：湖南省卫计委资助项目(编号:B2016134)

摘　　要：目的：观察右美托咪定和咪达唑仑镇静辅助治疗急性期主动脉夹层患者的作用。方法：选择急性期主动脉夹层患者72例，随机将患者分为静脉泵注右美托咪定组（D组），静脉泵注咪达唑仑组（M组）。记录两组患者用药前后不同时间点（T0-T6）的呼吸频率（RR）、动脉血氧饱和度（SpO2）、以及治疗24h内地尔硫卓和吗啡的用量、治疗1周内谵妄发生率及持续时间。结果：与T0时点相比，D组在T1-T6时点RR和SpO2无明显变化，差异无统计学意义（p〉0．05），M组在T1-T6时点RR和SpO2明显降低，差异有统计学意义（P〈0．05）；与M组比较，D组患者24h吗啡及地尔硫卓用量少于M组，差异有统计学意义（P〈0．05）；此外，D组患者1周谵妄发生率和持续时间明显降低，差异有统计学意义（P〈0．05）。结论：右美托咪定用于急性期主动脉夹层患者镇静时呼吸抑制作用弱、降压和镇痛药物用量少和谵妄发生率低．优于咪达唑仑镇静．Objective To investigate the auxiliary effects of dexmedetomidine and midazolam on patients with acute aortic dissection. Methods Seventy-two perioperative patients diagnosed as aortic dissection were selected and randomly divided into group D and group M. Patients received intravenous injection with dexmedetomidine in group D or midazolam in group M. All patients were intravenously administrated with morphine and dihiazem. The levels of RR and SpO2 were detected in the two groups. The 24 h consumption of diltiazem and morphine in, the delirium incidence within one week and the delirium duration were also recorded, respectively. Results In group D, no significant differences for RR and SpO2 were observed between To and Tl - T6 time points （P 〉 0.05 ）. However, midazolam significantly decreased RR and SpO2 in T1 - T6 time points when compared with To time point （P 〈 0.05）. Moreover, the comsumptions of morphine and diltiazem in group D were less than those in group M. In addition, the incidence and duration of delirium in group D were lower than those in group M （P 〈 0.05）. Conclusion For patients with acute aortic dissection, dexmedetomidine sedation is better than midazolam, with weaker respiratory inhibition, less antihypertensive and analgesic drug consumption and lower incidence of delirium.

关 键 词：右美托咪定 咪达唑仑 主动脉夹层 镇静 镇痛 

分 类 号：R614[医药卫生—麻醉学]