中国药物警戒 ›› 2010, Vol. 7 ›› Issue (9): 515-516.

• 基础研究 • 上一篇    下一篇

盐酸右美托咪定用于机械通气患者镇静的临床观察

田昭涛,黄鹤   

  1. 济南军区总医院重症医学科,山东济南 250031
  • 收稿日期:2010-07-20 修回日期:2016-03-09 出版日期:2010-09-08 发布日期:2016-03-09
  • 作者简介:田昭涛,男,副主任医师,危重病诊治。

The Clinical Effect of Dexmedetomidine in Ventilated Patients Sedation

TIAN Zhao-tao ,HUANG He   

  1. Department of Intensive Care Unit, General Hospital of PLA,Shandong Jinan 250031, China
  • Received:2010-07-20 Revised:2016-03-09 Online:2010-09-08 Published:2016-03-09

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摘要： 目的 探讨以盐酸右美托咪定为基础的镇静对重症监护病房（ICU）机械通气患者镇静效果的影响。方法 40 例需机械通气的内科患者随机分为咪达唑仑组（A组）和盐酸右美托咪定+咪达唑仑组（B 组）,每组20例。记录镇静前的APACHEⅡ评分、Ramsay 评分和PaO2/FiO2指标。记录镇静中4h、6h 和12h 的心率、血压和呼吸。镇静达12h 时停止药物输注,每30 min 评估1次镇静深度,记录恢复时间,达到满意镇静深度的时间,镇静满意程度。结果90%患者单独使用盐酸右美托咪定就能达到满意的镇静效果,如果联合使用咪达唑仑也只需要很低的剂量。比较咪达唑仑用量、调整泵速至镇静满意时间和恢复时间,B 组均明显少于A 组（ P<0.05）；B 组的镇静满意程度明显高于A 组（ P<0.05）。结论 对机械通气的患者以盐酸右美托咪定为基础的镇静能提高咪达唑仑的镇静效果。

关键词: 机械通气, 镇静, 咪达唑仑, 盐酸右美托咪定

Abstract: Objective To explore the sedative effects of dexmedetomidine asa ward-based sedation on ventilated patients in intensive care unit. Methods Forty ventilated patients were divided into midazolam group(group A) and midazolam+ dexmedetomidine group(group B),with 20 patients in each group. Recorded the APACHE II score, Ramsay score and PaO2/FiO2 indicators before sedation. Heart rate, blood pressure and respiration were recorded at 4h, 6h and 12h of sedation. The infusion were ceased after 12h, then the sedative degree was assessed every 30 min, recover time, time to achieve satisfactory sedation and the sedation level were recorded. Results 90% of patients could achieve satisfactory sedation using dexmedetomidine alone, if the joint use of midazolam has only very low doses. The midazolam dosage, time to achieve satisfactory sedation and recover time in group B decreased significantly than those in Group A( P<0.05). Satisfactory degree of sedation in group B were higher than those in group A( P<0.05). Conclusion In medical ventilated patients, dexmedetomidine can improve the sedative efect of midazolam.

Key words: mechanical ventilation, sedation, midazolam, dexmedetomidine

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