观察右美托咪定在机械通气患者镇静治疗中的有效性和安全性  

Observation on efficacy and safety of dexmedetomidine in sedative treatment of patients with mechanical ventilation

作　　者：董勇[1] 周杰 DONG Yong ZHOU Jie(Intensive Care Unit, Dazhou City Dazhu County People＇ s Hospital, Dazhou 635100, China)

机构地区：[1]达州市大竹县人民医院重症监护室,635100

出　　处：《中国实用医药》2017年第27期112-114,共3页China Practical Medicine

摘　　要：目的观察右美托咪定在机械通气患者镇静治疗中的有效性和安全性。方法 60例重症监护病房(ICU)收治的机械通气需要镇静的患者,按照随机原则分为右美托咪定组和咪达唑仑组,各30例。右美托咪定组给予右美托咪定镇静治疗;咪达唑仑组给予咪达唑仑镇静治疗。观察两组患者的Ramsay评分、疼痛数字评分法(NRS)评分、机械通气时间、唤醒时间、拔管时间及患者不良反应发生情况。结果右美托咪定组的Ramsay评分与咪达唑仑组比较,差异无统计学意义(P>0.05);右美托咪定组的NRS评分低于咪达唑仑组,机械通气时间、唤醒时间、拔管时间均短于咪达唑仑组,差异均具有统计学意义(P<0.05)。右美托咪定组低血压发生率为20.00%、心动过缓发生率为16.67%,咪达唑仑组分别为16.67%、13.33%,比较差异均无统计学意义(P>0.05);右美托咪定组呼吸抑制发生率为0、谵妄发生率为10.00%,均低于咪达唑仑组的16.67%、36.67%,差异均具有统计学意义(P<0.05)。结论右美托咪定缩短机械通气时间及拔管时间,停药后唤醒快,谵妄发生率低,有利于重症患者的转归,值得推广。Objective To observe the efficacy and safety of dexmedetomidine in sedative treatment of patients with mechanical ventilation. Methods A total of 60 mechanical ventilation patients requiring sedation in intensive care unit （ICU） were randomly divided into dexmedetomidine group and midazolam group, with 30 eases in each group. Dexmedetomidine group received dexmedetomidine for sedative therapy, and midazolam group received midazolam for sedative therapy. Observation were made on Ramsay score, numerical rating scale （NRS） score, mechanical ventilation time, wake-up time, extubation time and occurrence of adverse reactions in two groups. Results Dexmedetomidine group had no statistically significant difference in Ramsay score comparing with midazolam group （P〉0.05）. Dexmedetomidine group had lower NRS score than midazolam group, and shorter mechanical ventilation time, wake-up time, extubation time than midazolam group. Their difference was statistically significant （P〈0.05）. Dexmedetomidine group had incidence of hypotension as 20.00%, and incidence of bradycardia as 16.67%, which were 16.67% and 13.33% in midazolam group. Their difference was statistically significant （P〉0.05）. Dexmedetomidine group had lower incidence of respiratory depression as 0, and incidence of delirium as 10.00% than 16.67% and 36.67% in midazolam group, and their difference was statistically significant （P〈0.05）. Conclusion Dexmedetomidine can shorten the time of mechanical ventilation and extubation time, and patients wake up quickly after withdrawal with low incidence of delirium. So it is beneficial to the prognosis of critically ill patients and worthy of promotion.

关 键 词：右美托咪定 镇静 安全性 

分 类 号：R614[医药卫生—麻醉学]