右美托咪定联合布托啡诺对高血压性脑出血病人镇痛、镇静的疗效观察  

Clinical effect of dexmedetomidine combined with butofinol on analgesia and sedation in patients hypertensive cerebral hemorrhage

作　　者：王本琳 王慧星[1] 周海旭 袁阳 WANG Ben- lin;WANG Hui- xing;ZHOU Hai- xu;YUAN Yang(Department of Neurosurgery, The 970th Hospital, PLA, Yantai264000, China)

机构地区：[1]中国人民解放军第970医院神经外科,山东烟台264000

出　　处：《中国临床神经外科杂志》2018年第12期792-794,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨右美托咪定联合酒石酸布托啡诺对高血压性脑出血病人的镇痛、镇静的有效性及安全性。方法选择2017年7月至2018年6月收治的高血压性脑出血50例,根据镇痛、镇静方法分为观察组(25例)和对照组(25例)。观察组应用右美托咪定联合布托啡诺,对照组应用盐酸异丙嗪+盐酸氯丙嗪。采用视觉模拟量表(VAS)评分评估镇痛效果和呕心呕吐程度,采用Ramsay评分评估镇静效果,同时记录收缩压、舒张压、心率等血流动力学指标。结果用药后2、6、12、24 h,观察组镇痛VAS评分均明显低于对照组(P<0.05)。用药后6、12、24 h,观察组Ramsay评分均明显低于对照组(P<0.05)。用药后12、24 h,观察组恶心、呕吐程度VAS评分均明显低于对照组(P<0.05)。用药后24 h,观察组心率明显低于对照组(P<0.05);用药后2、6、12、24 h,观察组收缩压均明显低于对照组(P<0.05);用药后6、12、24 h,观察组舒张压均明显低于对照组(P<0.05)。结论对高血压性脑出血,联合应用右美托咪定和布托啡诺,具有良好的镇痛、镇静作用,并且可降低恶心、呕吐的发生率。Objective To evaluate the efficacy and safety of dexmedetomidine combined with butofinol in the patients with hypertensive cerebral hemorrhage(HCH).Methods Of50patients with HCH,30(observed group)were treated by dexmetomidine combined with butofinol and20(control group)was treated with iprazine hydrochloride and chlorpromazine hydrochloride.The scores of visual analogue scale(VAS)and Ramsay sedation scale,blood pressure,the incidence of nausea and vomiting were determined and compared between the two groups.Results The scores of VAS and Ramsay sedation scale,systolic and diastolic blood pressures and incidence of nausea and vomiting were significantly lower in the observed group than those in the control group2,6,12and24hours after the treatment(P<0.05).Conclusions Dexmedetomidine combined with butofinol can effectively reduce the restlessness and incidence of nausea and vomiting,and has good analgesic and sedative effects compared to iprazine hyarochloride and clorpromazine hyarochloride in the patients with HCH.

关 键 词：高血压性脑出血 右美托咪定 布托啡诺 镇痛 镇静 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]