右美托咪定或咪达唑仑复合舒芬太尼在有创机械通气患者镇静中的效果对比  

Comparison of sedation effects of Dexmedetomidine or Midazolam combined with Sufentanil in patients undergoing invasive mechanical ventilation

作　　者：张妍[1] 苏晓蕾[1] 赵睿[1] 朱虹[1] 房开宇[1] ZHANG Yan;SU Xiao-lei;ZHAO Rui;ZHU Hong;FANG Kai-yu(Second Ward of Intensive Care Unit of Dalian Central Hospital,Liaoning Province,Dalian 116033,China)

机构地区：[1]大连市中心医院重症监护病房第二病房,辽宁大连116033

出　　处：《中国当代医药》2019年第5期181-183,202,共4页China Modern Medicine

摘　　要：目的探讨右美托咪定或咪达唑仑复合舒芬太尼在有创机械通气中的镇静效果。方法选取2017年6月～2018年6月来我院行有创机械通气的102例患者,按随机数字表法分为对照组和观察组,每组各51例,对照组采取咪达唑仑复合舒芬太尼镇静方案,观察组采取右美托咪定复合舒芬太尼镇静方案,比较两组机械通气时间、唤醒时间、住ICU时间及不良反应发生情况,同时分别于用药前、用药后6、12、24 h监测两组的Ramsay评分、心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2)指标。结果观察组机械通气时间、唤醒时间短于对照组(P<0.05);而两组住ICU时间比较,差异无统计学意义(P>0.05);观察组不良反应总发生率低于对照组(P<0.05);两组用药后6、12、24 h时HR、MAP水平较用药前均降低,SpO_2水平升高,且观察组HR、MAP低于对照组,SpO_2水平高于对照组(P<0.05);两组用药后6、12、24 h时Ramsay评分较用药前均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论对有创机械通气患者采取右美托咪定复合舒芬太尼方案可取得良好的镇静效果,能稳定患者生命体征,且不良反应少。Objective To explore the sedative effect of Dexmedetomidine or Midazolam combined with Sufentanil in invasive mechanical ventilation.Methods Selected 102 patients with invasive mechanical ventilation in our hospital from June 2017 to June 2018,according to random number table method,they were divided into control group and observation group,51 cases in each group.The control group was sedated by Midazolam combined with Sufentanil,while the observation group was sedated by Dexmedetomidine combined with Sufentanil.The mechanical ventilation time,awakening time,ICU time and adverse reactions were compared between the two groups.Ramsay score,heart rate(HR),mean arterial pressure(MAP)and blood oxygen saturation(SpO2)were monitored before and 6,12 and 24 hours after treatment.Results The mechanical ventilation time and wake-up time in the observation group were shorter than those in the control group(P<0.05),but there was no statistical difference between the two groups when they were living in ICU(P >0.05);the total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).The levels of HR and MAP in the two groups at 6,12 and 24 h after treatment was lower than those before treatment,the spO2 level increased,and HR and MAP in the observation group were lower than those in the control group,SpO2 level was higher than that of control group(P<0.05).The Ramsay scores of the two groups at 6,12 and 24 hours after treatment was higher than those before treatment,and that of the observation group was higher than that of the control group(P<0.05).Conclusion Dexmedetomidine combined with Sufentanil for invasive mechanical ventilation patients can achieve good sedative effect,stabilize the vital signs of patients,and have fewer adverse reactions.

关 键 词：机械通气 右美托咪定 舒芬太尼 咪达唑仑 镇静效果 

分 类 号：R969.4[医药卫生—药理学]