右美托咪定联合丙泊酚对急性主动脉夹层患者镇静镇痛的效果评价  

Evaluation on clinical efficacy of sedation and analgesia in patients of acute aortic dissection with using combination of dexmedetomidine and propofol

作　　者：闫波[1] 郑荣耀 杨东亮[1] 张全梅[1] YAN Bo;ZHENG Rongyao;YANG Dongliang;ZHANG Quanmei(Department of Pharmacy,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院药学部,乌鲁木齐830054

出　　处：《新疆医科大学学报》2022年第6期634-638,共5页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81960097)。

摘　　要：目的评价右美托咪定联合丙泊酚对急性主动脉夹层患者镇静镇痛作用的效果。方法选取2018年7月-2021年6月新疆医科大学第一附属医院心脏中心收治的170例急性期的主动脉夹层患者为研究对象,随机分为对照组(n=84)和试验组(n=86)。对照组静脉注射丙泊酚(2.5 mg/kg体重,1 h后追加注射1 mg/kg体重);试验组泵注右美托咪定(10 min内缓慢静脉泵注1μg/kg体重),再注射丙泊酚(2 mg/kg体重)。比较两组患者在入院用药前、入院用药后10 min、用药后4、12和24 h的血流动力学参数、降压药物的使用剂量、镇痛(Ramsay)和疼痛(VAS)评分、镇静评分、谵妄发生率和认知状况评分。结果与对照组患者用药后4、12和24 h比较,试验组患者平均动脉压、心率和呼吸频率均升高,VAS和Ramsay评分均降低,认知状态明显改善,差异有统计学意义(P<0.05)。与对照组患者使用的镇痛及降压药剂量比较,试验组患者的使用剂量降低,差异有统计学意义(P<0.05)。结论右美托咪定联合丙泊酚能够稳定急性主动脉夹层患者的血流动力学指标,降低镇痛和降压药物的使用剂量,改善患者的疼痛和镇静效果,保护患者的认知功能。Objective To evaluate the effect of dexmedetomidine combined with propofol on sedation and analgesia in patients with acute aortic dissection.Methods One hundred and seventy patients suffered with acute aortic dissection and admitted to the hospital from July 2018 to June 2021 as subjects,constituting 84 cases in the control group and 86 cases in the trial group.Propofol was applied alone in the control group(intravenous injection of 2.5 mg/kg for the first time,and additional injection of 1 mg/kg after 1 hour)and dexmedetomidine was pumped(slowly intravenous pump 1μg/kg within 10 minutes)followed by propofol(intravenous injection 2 mg/kg)in the trial group.Hemodynamic param⁃eters,dosages of analgesic and antihypertensive drugs,paining scores,sedative scores,incidence of delirium and cog nitive status scores were compared between the two groups at the time of admission(before taking medicine),10 min af⁃ter admission medication,4 h,12 h,and 24 h after admission with medication.Results Compared with the control group at 4,12 and 24 hours after the treatment,.The average arterial pressure,heart rate and respiratory rate in the ex⁃perimental group were increased;the VAS and Ramsay scores were decreased;and cognitive state improved signifi⁃cantly(P<0.05).Compared with the control group,the dosage of antihypertensive drugs was also significantly lower(P<0.05).Conclusion Dexmedetomidine combined with propofol can stabilize the hemodynamic indexes in patients with acute aortic dissection and reduce the dosage of analgesic and antihypertensive drugs,to improve the pain and sedative effect of the patients,so as to protect the cognitive function.

关 键 词：右美托咪定 丙泊酚 主动脉夹层 镇静 镇痛 

分 类 号：R969[医药卫生—药理学]