摘要
目的:探讨咪达唑仑序贯右美托咪定在重症监护室(ICU)机械通气重症患者中镇静效果及对谵妄的预防效果。方法:选取2020年7月-2021年8月某院ICU收治的机械通气重症患者60例,采用随机数字表法将患者均分为对照组和观察组各30例,对照组采用单用右美托咪定镇静,观察组采用咪达唑仑序贯右美托咪定镇静。采用躁动/镇静评分量表(Richmond Agitation-Sedation Scale,RASS)评价镇静效果,同时比较两组镇静起效时间、停药后苏醒时间,调查患者谵妄、不良反应发生情况。结果:观察组给药5min、给药15min、给药1h时期RASS评分均低于对照组,差异有统计学意义(P<0.05);观察组镇静起效时间短于对照组(P<0.05),停药后苏醒时间对比差异不显著(P>0.05);镇静期间观察组谵妄发生率低于对照组,差异有统计学意义(P<0.05);镇静期间观察组低血压、心动过缓、高血压发生率相较对照组,差异无统计学意义(P<0.05)。结论:咪达唑仑序贯右美托咪定在ICU机械通气重症患者镇静中效果理想,可有效减轻患者痛苦,缩短镇静所需时间并降低谵妄的发生,此外该镇静方案的安全性较高。
Objective:To investigate the sedative effect of midazolam sequential dexmedetomidine in severe patients with mechanical ventilation in intensive care unit(ICU)and its preventive effect on delirium.Methods:60 severe patients with mechanical ventilation treated in ICU of a hospital from July 2020 to August 2021 were selected and divided into two groups by random number table method,with 30 cases in each group.The control group was sedated with dexmedetomidine alone,and the observation group was sedated with midazolam sequential dexmedetomidine.The sedative effect was evaluated by Richmond Agitation-Sedation Scale(RASS).At the same time,the onset time of sedation and recovery time after drug withdrawal were compared between the two groups,and the incidence of delirium and adverse reactions were investigated.Results:The RASS scores of the observation group at 5 min,15 min and 1 h were lower than those of the control group,and the difference was statistically significant(P<0.05).The onset time of sedation in the observation group was shorter than that in the control group(P<0.05).There was no significant difference in recovery time after drug withdrawal(P>0.05).During sedation,the incidence of delirium in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).During sedation,there was no significant difference in the incidence of hypotension,bradycardia and hypertension between the observation group and the control group(P<0.05).Conclusion:Midazolam sequential dexmedetomidine has an ideal effect in sedation of severe patients with mechanical ventilation in ICU,which can effectively reduce the pain of patients,shorten the time required for sedation and reduce the incidence of delirium.In addition,the sedation scheme has high safety.
作者
梅英杰
莫必华
曾德志
甘国能
刘冠雄
彭伟
Mei Yingjie;Mo Bihua;Zeng Dezhi;Gan Guoneng;Liu Guanxiong;Peng Wei(Department of Critical Care Medicine,Yunfu People's Hospital,Guangdong Province,Yunfu 527300)
出处
《数理医药学杂志》
CAS
2022年第6期840-842,共3页
Journal of Mathematical Medicine
基金
云浮市科技计划项目(项目编号ws202007)。
关键词
咪达唑仑
右美托咪定
重症患者
机械通气
镇静
谵妄
midazolam
dexmedetomidine
severe patients
mechanical ventilation
sedation
delirium
