镇痛镇静用于ICU重症脓毒血症患者治疗中的临床效果观察  

Clinical observation of analgesia and sedation in the treatment of patients with severe sepsis in ICU

作　　者：郝西源 HAO Xi-yuan(Shenyang Red Cross Hospital,Shenyang 110013,China)

机构地区：[1]沈阳市红十字会医院,110013

出　　处：《中国现代药物应用》2023年第19期109-111,共3页Chinese Journal of Modern Drug Application

摘　　要：目的 分析镇痛镇静用于重症加强护理病房(ICU)重症脓毒血症患者治疗中的临床效果。方法 80例ICU重症脓毒血症患者为研究对象,按随机数字表法分为对照组及观察组,各40例。对照组使用硫酸吗啡缓释片镇痛镇静,观察组使用枸橼酸芬太尼注射液联合咪达唑仑注射液镇痛镇静。比较两组治疗前后的视觉模拟评分法(VAS)评分,镇静效果(镇静时间及停药后唤醒时间),治疗前后的相关血液流变学指标(全血高切粘度、全血低切粘度、血浆粘度)水平。结果 治疗后,观察组的VAS评分(3.2±0.1)分低于对照组的(4.9±0.2)分,差异具有统计学意义(P<0.05)。观察组镇静时间为(96.5±9.3)min、停药后唤醒时间为(120.3±19.7)min,均长于对照组的(82.4±9.1)、(97.5±19.2)min,差异具有统计学意义(P<0.05)。治疗后,观察组全血高切粘度(4.70±1.34)mPa·s、全血低切粘度(12.31±1.79)mPa·s、血浆粘度(4.00±1.54)mPa·s均低于对照组的(7.65±1.31)、(18.26±1.78)、(5.96±0.83)mPa·s,差异具有统计学意义(P<0.05)。结论 在ICU重症脓毒血症患者治疗中使用枸橼酸芬太尼注射液联合咪达唑仑注射液的镇痛镇静效果优良,具备推广及使用的价值。Objective To analyze the clinical effect of analgesia and sedation in the treatment of patients with severe sepsis in intensive care unit(ICU).Methods A total of 80 patients with severe sepsis in ICU were divided into control group and observation group according to random numerical table,with 40 cases in each group.The control group was given morphine sulfate sustained-release tablets for analgesia and sedation,and the observation group was given fentanyl citrate injection combined with midazolam injection for analgesia and sedation.Both groups were compared in terms of visual analogue scale(VAS)score,sedation effect(sedation time and wake-up time after drug withdrawal),and relevant hemorheological indexes(whole blood viscosity at high shear,whole blood viscosity at low shear,plasma viscosity)before and after treatment.Results After treatment,VAS score of(3.2±0.1)points in the observation group was lower than that of(4.9±0.2)points in the control group,and the difference was statistically significant(P<0.05).The observation group had sedation time of(96.5±9.3)min and wake-up time after drug withdrawal of(120.3±19.7)min,which were longer than those of(82.4±9.1)and(97.5±19.2)min in the control group,and the differences were statistically significant(P<0.05).After treatment,the observation group had whole blood viscosity at high shear of(4.70±1.34)mPa·s,whole blood viscosity at low shear of(12.31±1.79)mPa·s,and plasma viscosity of(4.00±1.54)mPa·s,which were lower than those of(7.65±1.31),(18.26±1.78)and(5.96±0.83)mPa·s in the control group,and the differences were statistically significant(P<0.05).Conclusion In the treatment of patients with severe sepsis in ICU,fentanyl citrate injection combined with midazolam injection has excellent analgesic and sedative effect,and has the value of popularization and use.

关 键 词：镇痛镇静 重症加强护理病房 重症脓毒血症 枸橼酸芬太尼注射液 咪达唑仑注射液 硫酸吗啡缓释片 

分 类 号：R459.7[医药卫生—急诊医学]