摘要
目的探讨右美托咪定对机械通气联合血液净化患者镇静效果和对呼吸力学的影响。方法选择2021年1月~2022年12月在浙江省舟山医院接受机械通气联合血液净化治疗的ICU患者50例,按随机数字表法分为右美托咪定组和咪达唑仑组,每组25例。右美托咪定组和咪达唑仑组分别给予右美托咪定、咪达唑仑镇静处理,同时两组均给予舒芬太尼镇痛治疗,比较两组镇静效果、临床相关指标、血流动力学指标、呼吸力学指标及不良事件的发生情况。结果两组镇静满意率、获得满意镇静效果的时间差异无统计学意义(P>0.05);右美托咪定组ICU住院时间、机械通气时间及清醒时间短于咪达唑仑组,舒芬太尼使用剂量少于咪达唑仑组(P<0.05);右美托咪定组镇静后1小时的MAP、HR低于同期咪达唑仑组(P<0.05);右美托咪定组Cdyn、WOBp高于咪达唑仑组,Ppeak、Pplat低于咪达唑仑组(P<0.05);两组各不良事件发生率差异无统计学意义(P>0.05)。结论对ICU机械通气联合血液净化的ICU患者,使用右美托咪定镇静可获得满意的效果,并可改善血流动力学及呼吸力学状态,且未增加不良事件的发生。
Objective To explore the sedative effect of dexmedetomidine on ICU patients undergoing mechanical ventilation combined with blood purification and its impact on respiratory mechanics.Method Fifty ICU patients who received mechanical ventilation combined with blood purification treatment at Zhoushan Hospital in Zhejiang Province from January 2021 to December 2022 were randomly divided into a dexmedetomidine group and a midazolam group using a random number table method,with 25 patients in each group.The dexmedetomidine group and midazolam group were given sedative treatment with dexmedetomidine and midazolam,respectively.At the same time,both groups were given sufentanil analgesic treatment.The sedative effect,clinical related indicators,hemodynamic indicators,respiratory mechanics indicators,and incidence of adverse events were compared between the two groups.Results There was no statistically significant difference in the satisfaction rate of sedation and the time to achieve satisfactory sedation effect between the two groups(P>0.05);The ICU hospitalization time,mechanical ventilation time,and wakefulness time after discontinuation of the dexmedetomidine group were shorter than those of the midazolam group,and the dosage of sufentanil was lower than that of the midazolam group(P<0.05);The MAP and HR of the dexmedetomidine group after 1 hour of sedation were lower than those of the midazolam group during the same period(P<0.05);The Cdyn and WOBp in the dexmedetomidine group were higher than those in the midazolam group,while Ppeak and Pplat were lower than those in the midazolam group(P<0.05);There was no statistically significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion For ICU patients undergoing mechanical ventilation combined with blood purification,the use of dexmedetomidine sedation can achieve satisfactory results and improve hemodynamic and respiratory status without increasing the incidence of adverse events.
作者
刘淼
邓杰
董科奇
LIU Miao;DENG Jie;DONG Keqi(Zhoushan Hospital,Zhoushan 316021,China)
出处
《浙江实用医学》
2024年第1期15-18,共4页
Zhejiang Practical Medicine
基金
舟山市科技计划项目(2020C31054)。
关键词
ICU
机械通气
血液净化
右美托咪定
咪达唑仑
镇静
呼吸力学
mechanical ventilation
blood purification
Dexmedetomidine
Midazolam
calm down
respiratory mechanics
