右美托咪定治疗高血压脑出血患者的效果观察  

The therapeutic effects of dexmedetomidine on hepertensive intracerebral hemorrhage

作　　者：宋贺[1] 门焕丽 张花平 张栋梁[2] 苏现辉[2] SONG He;MEN Huanli;ZHANG Huaping(Department of Neurological ICU,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuag 050011,China)

机构地区：[1]河北省石家庄市第一医院神经ICU,050011 [2]河北省石家庄市第一医院神经外科,050011

出　　处：《河北医药》2019年第18期2758-2761,共4页Hebei Medical Journal

基　　金：河北省科技厅健康医疗与生物医药专项(编号:172777195)

摘　　要：目的评价高血压脑出血患者入住神经ICU后,使用右美托咪定达到目标镇静后的效果、一般生命体征、动脉血气指标及预后的影响。方法140例高血压性脑出血并采取非手术干预的患者作为研究对象,采用随机数字法分为对照组和观察组,每组70例。对照组给予常规综合治疗,观察组在观察组治疗方案的基础上泵点右美托咪定静脉行镇痛镇静治疗。比较2组患者入住神经ICU后相同时间点的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、唤醒后的昏迷评分(GCS),随访3~6个月,比较2组患者的预后(GOS评分)。结果观察组在入住神经ICU后12、24、48、72h的内的HR、RR、MAP均低于对照组(P<0.05);观察组(PaO2、PaCO2与对照组比较,差异无统计学意义(P>0.05);唤醒后GCS评分、随访3~6个月GOS评分,观察组的明显优于对照组(P<0.05)。结论 高血压脑出血患者在发病入住神经ICU后使用右美托咪定镇痛镇静,效果明显,可稳定生命体征,对意识状态评估无显著影响,安全性高,无呼吸抑制,促进恢复,改善预后。Objective To investigate the therapeutic effects of dexmedetomidine on hepertensive intracerebral hemorrhage by observing the sedation effects,vital signs,arterial blood gas indexes and prognosis of patients.Methods One hundred and forty patients with hepertensive intracerebral hemorrhage who were admitted and treated in NICU of our hospital from December 2017 to August 2018 were randomly divided into the control group and the observation group,with 70 cases in each group.The patients control group were given conventional comprehensive treatment,however,the patients in observation group were treated by dexmedetomidine intravenous injection.The heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),arterial oxygen partial pressure(PaO2),arterial carbon dioxidepartial pressure(PaCO2),GCS scores after wake-up and after 3~6 follow-up were observed and compared between the two groups.Results The levels of HR,RR,MAP in observation group were significantly lower than those in control group at 12 h,24 h,48 h,and 72 h after admiting into NICU(P<0.05).There were no significant differences in the levels of PaO2 and PaCO2 between the two groups(P>0.05).Moreover the GCS scores after wake-up and after 3~6 follow-up in observation group were superior to those in control group(P<0.05).Conclusion The application of dexmedetomidine for patients with hepertensive intracerebral hemorrhage can stabilize the patient’s vital signs,significantly improve the sedation effects,promote recovery,improve patient’s prognosis,with higher safety without respiratory inhibition.

关 键 词：高血压脑出血 右美托咪定 镇痛镇静 生命体征 预后 

分 类 号：R971.2[医药卫生—药品]