右美托咪定与咪达唑仑在ICU长期机械通气患者中镇静效果及安全性对照研究

中国药物警戒 ›› 2018, Vol. 15 ›› Issue (3): 140-143.

右美托咪定与咪达唑仑在ICU长期机械通气患者中镇静效果及安全性对照研究

杨波¹, 赵玉良², 周文博³, 王旭东⁴, 姜军号⁵, 刘海生⁶

1 徐州市药品不良反应监测中心，江苏徐州221000；
2 徐州市第一人民医院，江苏徐州221000；
3 徐州市中医院，江苏徐州221000；
4 徐州市矿务局总医院, 江苏徐州221000；
5 徐州市沛县人民医院，江苏徐州221000；
6 徐州市睢宁人民医院，江苏徐州221000

收稿日期:2017-12-27 修回日期:2018-05-04 出版日期:2018-03-20 发布日期:2018-05-04
通讯作者: 刘海生，男，本科，主任医师，危重症医学疼痛治疗。E-mail：snyylhs@163.com
作者简介:杨波，男，本科，药品不良反应监测。

Comparison of Sedative Effect and Safety of Midazolam and Dexmedetomidine on ICU Patients with Long-term Mechanical Ventilation

YANG Bo¹, ZHAO YU-liang², ZHOU Wen-bo³, WANG Xu-dong⁴, JIANG Jun-hao⁵, LIU Hai-sheng⁶

1 Xuzhou Drug Adverse Reaction Testing Center, Jiangsu Xuzhou 221000, China;
2 Xuzhou First People's Hospital, Jiangsu Xuzhou 221000, China;
3 Xuzhou City Hospital of TCM, Jiangsu Xuzhou 221000, China;
4 Second Affiliated Hospital of Xuzhou Medical University, Jiangsu Xuzhou 221009, China;
5 Xuzhou Peixian People's Hospital, Jiangsu Xuzhou 221000, China; 6Xuzhou Suining People's Hospital, Jiangsu Xuzhou 221000, China

Received:2017-12-27 Revised:2018-05-04 Online:2018-03-20 Published:2018-05-04

摘要/Abstract

摘要： 目的比较右美托咪定与咪达唑仑对ICU长期机械通气患者的镇静效果及安全性。方法选取2016年6月至2017年6月期间长期机械通气的ICU患者120例，随机分为对照组和观察组，每组60例，对照组为咪达唑仑组，观察组为右美托咪定组。观察两组患者的 Ramsay镇静评分、机械通气时间、瑞芬太尼用量、达到理想镇静所需的时间、停药后苏醒时间、心率、血压及谵妄的发生率及其他不反应发生情况。结果观察组的机械通气时间及瑞芬太尼用量均较对照组明显降低，差异具有统计学意义（P <0.05）。观察组的镇痛效果较对照组明显提高，差异具有统计学意义（P <0.05）。观察组达理想镇静所需时间及停药后苏醒时间均较对照组明显缩短，差异具有统计学意义（P <0.05）。观察组的不良反应总发生率、低血压及心动过快发生率均较对照组明显降低（P <0.05），差异具有统计学意义。结论右美托咪定对于ICU长期机械通气患者的镇痛效果优于咪达唑仑，达理想镇静所需时间及停药后苏醒时间少于咪达唑仑，且不良反应、低血压及心动过快发生率少于咪达唑仑，得出其安全性优于咪达唑仑，值得临床推广与应用，但其仍存在一定的风险，临床应用仍需慎重。

关键词: 右美托咪定, 咪达唑仑, ICU患者, 机械通气, 安全性, 镇静效果

Abstract: Objective To compare the safety between midazolam and dexmedetomidine on ICU patients with long-term mechanical ventilation. Methods A total of 120 cases of ICU patients with long-term mechanical ventilation were randomly divided into the dexmedetomidine group (the observation group) and midazolam group (the control group). The patients in control group were given midazolam, while the patients in observation group received dexmedetomidine. Sedative effect, analgesic effect and incidence of adverse reactions of patients in two groups were compared. Results Duration of mechanical ventilation and the dosage of remifentanil of patients in observation group significantly lower than those of control group (P <0.05). Analgesic effect of patients in the observation group significantly higher than that in the control group (P <0.05). The time required to achieve the desired sedation and recovery time of patients in the observation group were significantly shorter than those in the control group (P <0.05). Incidence of adverse reactions of patients in the observation group significantly lower than those in the control group (P <0.05). Conclusion Compared with the traditional midazolam regimen, dexmedetomidine was associated with more analgesic effect, lower duration of mechanical ventilation and the dosage of remifentanil, shorter time required to achieve the desired sedation and recovery time, lower incidence of adverse reactions, hypotension and tachycardia in patients with long-term mechanical ventilation, which is worth clinical promotion.

Key words: dexmedetomidine, midazolam, ICU patient, mechanical ventilation, safety, sedative effect

中图分类号:

R971.2

杨波, 赵玉良, 周文博, 王旭东, 姜军号, 刘海生. 右美托咪定与咪达唑仑在ICU长期机械通气患者中镇静效果及安全性对照研究[J]. 中国药物警戒, 2018, 15(3): 140-143.

YANG Bo, ZHAO YU-liang, ZHOU Wen-bo, WANG Xu-dong, JIANG Jun-hao, LIU Hai-sheng. Comparison of Sedative Effect and Safety of Midazolam and Dexmedetomidine on ICU Patients with Long-term Mechanical Ventilation[J]. Chinese Journal of Pharmacovigilance, 2018, 15(3): 140-143.

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