咪达唑仑、丙泊酚和右美托咪定三种镇静方案在ICU重症患者中的应用效果比较  

Comparison on the Application Effects of Three Kinds of Sedative Regimens(Midazolam, Propofol and Dextromethorphan) in ICU Severe Patients

作　　者：潘挺军[1] 罗伟文[1] 

机构地区：[1]梅州市人民医院重症医学一科,广东梅州514089

出　　处：《临床医学工程》2018年第2期153-154,共2页Clinical Medicine & Engineering

基　　金：梅州市科技计划项目(项目编号:2016E031)

摘　　要：目的探讨咪达唑仑、丙泊酚及右美托咪定三种镇静方案在ICU重症患者中的应用效果。方法选取2014年6月至2017年4月我院ICU收治的需要镇静的重症患者120例为研究对象,随机分为A、B、C三组,分别给予咪达唑仑、丙泊酚及右美托咪定镇静,比较三组的镇静效果。结果 C组的谵妄发生率低于A、B两组,谵妄发生时间长于A、B两组(P<0.05)。镇静后,A、B两组的SBP、DBP水平较镇静前显著降低,C组的HR水平较镇静前显著降低(P<0.05);C组患者的SBP、DBP高于A、B两组,但HR低于A、B两组(P<0.05);三组患者的Sp O2水平比较无统计学差异(P>0.05)。B组、A组、C组的镇静达标时间、拔管时间、ICU住院时间均依次增加(P<0.05)。结论咪达唑仑、丙泊酚、右美托咪定在ICU重症患者中均能发挥镇静效果,丙泊酚、咪达唑仑的镇静效果相对右美托咪定更为显著,但对血压水平、谵妄发生的影响较明显,临床中应根据患者的具体情况合理选择镇静药物。Objective To explore the application effects of three kinds of sedative regimens （midazolam, propofol and dextromethorphan） in ICU severe patients. Methods 120 cases of ICU severe patients with sedation requirement in our hospital f^om June 2014 to April 2017 were selected as research objects, and randomly divided into group A （midazolam for sedation）, group B （propofol for sedation） and group C （dextromethorphan for sedation）, with 40 cases in each group. The sedation effects of three groups were compared. Results The incidence of delirium of group C was lower than that of group A and group B, and the occurrence time of delirium was significantly longer than that of group A and group B （.P〈0.05）. After sedation, group A and group B had significantly decreased SBP and DBP levels, and group C had significantly decreased HR level （P〈0.05）; The SBP and DBP levels of group C were significantly higher than those of group A and group B, and the HR level was significantly lower than that of group A and group B （P〈0.05）; No statistical difference was found among three groups in the SpO2 level （P〉0.05）. The standard time of sedation, extubation time and ICU hospitalization time of group B, group A and group C increased successively （P〈0.05）. Conclusions Midazolam, propofol and dexmedetomidine have significant sedative effect in ICU severe patients. Propofol and midazolam have more significant sedative effect than dexmedetomidine, but have more obvious effects on blood pressure and incidence of delirium. Sedative drugs should be selected according to patients＇ specific situation in clinic.

关 键 词：咪达唑仑 丙泊酚 右美托咪定 重症监护室 镇静 

分 类 号：R614[医药卫生—麻醉学]