咪达唑仑联合芬太尼对重症蛛网膜下腔出血患者脑代谢的影响  

Effect of Midazolam combined with Fentanyl on cerebral metabolism in patients with severe subarachnoid hemorrhage

作　　者：孙可心 SUN Ke-xin(Department of Critical Care Medicine,Fukuang General Hospital of Liaoning Health Industry Group,Liaoning Province,Fushun 113000,China)

机构地区：[1]辽宁省健康产业集团抚矿总医院重症医学科,辽宁抚顺113000

出　　处：《中国当代医药》2021年第31期99-102,共4页China Modern Medicine

摘　　要：目的探讨咪达唑仑联合芬太尼对重症蛛网膜下腔出血患者脑代谢的影响。方法选取2017年2月至2019年5月辽宁省健康产业集团抚矿总医院收治的40例重症蛛网膜下腔出血患者作为研究对象,按照入院顺序单双号分为对照组(20例)与观察组(20例),对照组采用右美托咪定药物镇痛镇静治疗方法,观察组采用咪达唑仑联合芬太尼药物镇痛镇静治疗方法。比较两组的镇静程度评估表(RASS)评分、重症监护室疼痛观察工具法(CPOT)评分、血氧饱和度。结果观察组治疗后30 min颈动脉血氧饱和度低于对照组,差异有统计学意义(P<0.05);观察组治疗后30 min颈静脉血氧饱和度与中心静脉血氧饱和度高于对照组,差异有统计学意义(P<0.05);观察组的治疗后RASS评分低于对照组,差异有统计学意义(P<0.05);两组治疗后CPOT评分比较,差异无统计学意义(P>0.05)。结论对重症蛛网膜下腔出血患者应用咪达唑仑联合芬太尼药物的镇静镇痛能够改善脑代谢,具有较好的治疗效果。Objective To explore the effect of Midazolam combined with Fentanyl on cerebral metabolism in patients with severe subarachnoid hemorrhage.Methods A total of 40 patients with severe subarachnoid hemorrhage admitted to Fukuang General Hospital of Liaoning Health Industry Group from February 2017 to May 2019 were selected and divided into control group(20 cases)and observation group(20 cases)according to the order of admission.The control group was treated with Dexmedetomidine and the observation group was treated with Midazolam combined with Fentanyl.The richmond agitation-sedation scale(RASS)score,intensive care unit pain observation tool(CPOT)score,and blood oxygen saturation were compared between the two groups.Results The carotid blood oxygen saturation of the observation group was lower than that of the control group 30 minutes after treatment,and the difference was statistically significant(P<0.05);the jugular venous blood oxygen saturation and central venous blood oxygen saturation of the observation group were higher than those of the control group 30 minutes after treatment,and the differences were statistically significant(P<0.05);the RASS score of the observation group after treatment was lower than that of the control group,and the difference was statistically significant(P<0.05);the CPOT score after treatment between the two groups was not statistically significant(P>0.05).Conclusion The application of Midazolam combined with Fentanyl for sedation and analgesia in patients with severe subarachnoid hemorrhage can improve brain metabolism and has a good therapeutic effect.

关 键 词：重症蛛网膜下腔出血 咪达唑仑 芬太尼 镇痛镇静 脑代谢 

分 类 号：R743.34[医药卫生—神经病学与精神病学]