机械通气患者右美托咪定和咪达唑仑两种镇静方法的疗效  

Efficacy of Dexmedetomidine and Midazolam in Sedation of Patients with Mechanical Ventilation

作　　者：张建功 马永昌 赵胜雷[1] 罗克金[1] ZHANG Jiangong;MA Yongchang;ZHAO Shenglei;LUO Kejin(The First Hospital of Fangshan District,Beijing 102400,China.)

机构地区：[1]北京市房山区第一医院,北京102400

出　　处：《药品评价》2021年第7期421-424,共4页Drug Evaluation

摘　　要：目的:比较重症医学科(ICU)内机械通气患者,右美托咪定和咪达唑仑两种镇静方法的有效性及安全性。方法:采用前瞻性单盲随机对照研究方法,选取北京市房山区第一医院重症医学科2018年10月至2020年10月入ICU且气管插管机械通气(>24 h)患者98例。在地佐辛有效镇痛基础上,将患者按照随机数字表法分为右美托咪定组(n=48)和咪达唑仑组(n=50)。记录两组患者机械通气时间,带气管插管时间,ICU住院时间,地佐辛用量,监测患者不良反应发生情况。结果:与咪达唑仑组相比,右美托咪定组患者机械通气时间、带气管插管时间及住ICU时间更短,患者使用镇痛药物(地佐辛)用量更少,差异有统计学意义(P<0.05)。右美托咪定组不良反应发生率更低,差异有统计学意义(P<0.05)。结论:在ICU机械通气患者治疗中,与咪达唑仑相比较,右美托咪定镇静可有效减少机械通气时间、气管插管时间、ICU住院时间及镇痛药物用量,减少不良反应发生率。Objective:To compare the efficacy and safety of dexmedetomidine and midazolam sedation for patients on mechanical ventilation in intensive care units(ICU).Methods:A prospective randomized controlled trial was conducted.From October 2018 to October 2020,98 cases of intubation mechanical ventilation(>24 h)patients admitted to ICU in The First Hospital of Fangshan District of Beijing were selected.Patients were divided into dexmedetomidine group(n=48)and midazolam group(n=50)according to the random number table,on the basis of dezocine effective analgesia.Dual mechanical ventilation,time with endotracheal intubation,ICU hospitalization,dosages of desocine in 2 groups were recorded,and the incidence of adverse events in patients was monitored.Results:Compared with midazolam group,dexmedetomidine group had shorter mechanical ventilation time,endotracheal intubation time and ICU stay time,and less analgesic drug(desoxocin)dosage,with statistical significance(P<0.05).The incidence of adverse reactions in the dexmedetomidine group was lower,and the difference was statistically significant(P<0.05).Conclusion:In the treatment of patients with mechanical ventilation in the ICU,compared with midazolam,dexmedetomidine sedation can effectively reduce the time of mechanical ventilation,endotracheal intubation,ICU stay and the dosage of analgesic drugs,and reduce the incidence of adverse reactions.

关 键 词：安定镇痛 右美托咪定 咪达唑仑 机械通气 谵妄 镇静 

分 类 号：R614[医药卫生—麻醉学]