右美托咪定联合瑞芬太尼对ICU机械通气患者镇静镇痛及CRP、PCT的影响  

Effects of dexmedetomidine combined with remifentanil on sedation and analgesia,CRP and PCT in patients with mechanical ventilation in ICU

作　　者：杨军英 魏民[1] 郑炜 赵建军 雷罗春 杨万春 张江成 张珂 YANG Jun-ying;WEI Min;ZHENG Wei;ZHAO Jian-jun;LEI Luo-chun;YANG Wan-chun;ZHANG Jiang-cheng;ZHANG Ke(Department of Intensive Care Unit,13th Division Xinjiang Production and Construction Corps,Red Star Hospital,Hami 839000,Xinjiang,China)

机构地区：[1]新疆生产建设兵团第十三师红星医院重症医学科,新疆哈密839000

出　　处：《川北医学院学报》2020年第5期872-874,917,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨右美托咪定联合瑞芬太尼对ICU机械通气患者镇静镇痛及CRP、PCT的影响。方法:按照治疗方式不同,将102例ICU机械通气患者分为两组,每组各51例。观察组使用右美托咪定联合瑞芬太尼治疗,对照组给予瑞芬太尼治疗。对两组患者给药后的收缩压、舒张压、每博输血量、心率等一般资料情况及苏醒时间、ICU住院时间、机械通气时间等情况进行对比分析,并比较两组患者给药前后视觉模拟评分法评分(VAS评分)、镇静评分标准(Ramsay评分)、C反应蛋白(CRP)、降钙素原(PCT)变化情况。结果:观察组患者给药后的苏醒时间[(1.25±0.21)min]、ICU住院时间[(5.38±1.23)d]及机械通气时间[(2.47±0.53)d]均少于对照组[(3.28±0.63)min、(7.63±1.73)d、(3.53±0.74)d](P<0.05)。观察组患者给药后的VAS评分[(3.27±0.64)分]低于对照组[(4.78±1.03)分],Ramsay评分[(2.78±0.72)分]高于对照组[(1.87±0.54)分](P<0.05)。观察组患者给药后的CRP、PCT水平[(15.35±3.22)mg/L、(1.57±0.34)ug/L]均低于对照组[(22.18±4.36)mg/L、(3.38±0.83)ug/L](P<0.05)。结论:右美托咪定联合瑞芬太尼对ICU机械通气患者镇静镇痛效果显著,可缩短患者恢复时间,降低CRP、PCT水平,值得临床推广应用。Objective:To investigate the effect of dexmedetomidine combined with remifentanil on sedation,analgesia,CRP and PCT in patients with mechanical ventilation in ICU.Methods:102 patients with mechanical ventilation in ICU were selected.All patients were divided into two groups according to the random number table method,with 51 cases in each group.The observation group was treated with dexmedetomidine combined with remifentanil,and the control group was given remifentanil.The systolic blood pressure,diastolic blood pressure,blood transfusion volume,heart rate,recovery time,ICU hospitalization time and mechanical ventilation time of patients in the two groups after administration were compared and analyzed.The changes of visual analog score(VAS score),sedation score(Ramsay score),C-reactive protein(CRP),and procalcitonin(PCT)before and after administration were compared between the two groups of patients.Results:The recovery time[(1.25±0.21)min],ICU hospital stay[[5.38±1.23]d],and mechanical ventilation time[(2.47±0.53)d]in the observation group were less than those in the control group[(3.28±0.63)min,(7.63±1.73)d,(3.53±0.74)d],the differences were statistically significant(P<0.05).The VAS score[(3.27±0.64)points]in the observation group was lower than that in the control group[(4.78±1.03)points],the Ramsay score[(2.78±0.72)points]were higher than that in the control group[(1.87±0.54)Points],the differences were statistically significant(P<0.05).The levels of CRP and PCT[(15.35±3.22)mg/L,(1.57±0.34)ug/L]in the observation group were lower than those in the control group[(22.18±4.36)mg/L,(3.38±0.83)ug/L],the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with remifentanil has a significant sedative and analgesic effect on patients with mechanical ventilation in ICU.It can shorten the recovery time,reduce CRP and PCT levels,and is worthy of clinical application.

关 键 词：右美托咪定 瑞芬太尼 ICU机械通气 镇静镇痛 C反应蛋白 降钙素原 

分 类 号：R614[医药卫生—麻醉学]