右美托咪定对以护士为主导的体外循环术后谵妄患者的应用效果  

Application Effect of Dexmedetomidine on Patients with Delirium after Nurse-Led Cardiopulmonary Bypass

作　　者：陈路洁 徐王慧 涂发妹[1] 戴少华[1] 熊建英[1] CHEN Lu-jie;XU Wang-hui;TU Fa-mei;DAI Shao-hua;XIONG Jian-ying(Department of Orthopedics,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China;Intensive Care Unit of Cardiac Surgery,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院骨科,南昌330000 [2]南昌大学第一附属医院心脏外科重症监护病房,南昌330000

出　　处：《四川解剖学杂志》2024年第6期29-31,共3页Sichuan Journal of Anatomy

基　　金：江西省卫生健康委科技计划项目(202310335)资助。

摘　　要：目的:探讨右美托咪定对以护士为主导的体外循环术后谵妄患者的应用效果.方法:选取2020年9月至2023年9月本院心脏外科重症监护病房收治的80例行体外循环手术患者作为研究对象.采用随机数字表法,将其分为观察组(n=40,给予右美托咪定治疗)和对照组(n=40,给予咪达唑仑治疗).比较两组患者气管插管时、拔管时和拔管后30min时的躁动镇静状态[Richmond躁动-镇静评分量表(RASS)],比较两组患者拔管后1、3、7d时谵妄发生情况及谵妄严重程度[重症监护谵妄筛查量表(ICDSC)].结果:拔管时、拔管后30min,观察组患者RASS评分均低于对照组,差异均有统计学意义(P<0.05);两组患者谵妄总发生率比较,差异无统计学意义(P>0.05);观察组患者谵妄持续时间短于对照组,差异有统计学意义(P<0.05);拔管后1、3、7d,观察组患者ICDSC评分均低于对照组,差异均有统计学意义(P<0.05).结论:右美托咪定对以护士为主导的体外循环术后谵妄患者的镇静效果较好,可缩短术后谵妄持续时间,降低术后谵妄严重程度.Objective:To explore the application effect of dexmedetomidine on patients with delirium after nurse-led cardiopulmonary bypass.Methods:A total of 80 patients who received elective cardiopulmonary bypass in intensive care unit of cardiac surgery of our hospital from September 2020 to September 2023 were selected as research subjects,and they were divided into observation group(n=40,treated with dexmedetomidine)and control group(n=40,treated with midazolam)by random number table method.The agitation and sedation state[Richmond agitation-sedation scale(RASS)]was compared at time of tracheal intubation,extubation and 30min after extubation.The occurrence of postoperative delirium and severity of postoperative delirium[intensive care delirium screening scale(ICDSC)]were compared at 1,3 and 7d after extubation.Results:The RASS scores at time of extubation and 30min after extubation in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of delirium between the two groups(P>0.05),but the duration of delirium in observation group was shorter than that in control group,and the difference was statistically significant(P<0.05).The ICDSC scores in observation control group at 1,3 and 7d after extubation were lower than those in control group,and the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine has a good sedative effect on delirium patients undergoing nurse-led cardiopulmonary bypass,which can shorten the duration of postoperative delirium and reduce the severity of postoperative delirium.

关 键 词：体外循环术 术后谱 右美托咪定 镇静效果 

分 类 号：R47[医药卫生—护理学]