摘要
目的对感染性休克患者临床常用的3种镇静方案进行评估和比较。方法采用简单随机对照研究方法，将45例感染性休克病例按镇静药物的使用分为3组，分别给予咪唑安定、丙泊酚和右美托咪啶镇静。观察3组患者的基础资料、机械通气时间、重症监护病房（ICU）住院时间、28d死亡率和外周血调节性T细胞（Treg）百分比。Treg检测由20例健康正常人作为对照组。结果3组患者28d死亡率和机械通气时间差异均无统计学意义（均P〉0．05），ICU住院时间咪唑安定组（19．7±5．7）d〉丙泊酚组（17．8±5．7）d〉右美托咪啶＋丙泊酚组（15．2±5．6）d，ICU住院时间右美托咪啶组较咪唑安定明显缩短（P〈0．05）。3组患者入ICU时外周血Treg百分比均明显高于健康对照组，右美托咪啶组治疗后第3天外周血Treg百分比和健康对照组比较差异无统计学意义（P〉0．05），而丙泊酚和咪唑安定组第5天外周血Treg百分比和健康对照组比较差异也无统计学意义（P〉0．05）。结论对于感染性休克的患者，右美托咪啶镇静的患者ICU住院时间最短，免疫抑制状态的时间也最短。
Objective To evaluated the 3 sedation regimen for patients with septic shock. Methods The randomized controlled trial wan conducted. Forty-five patients with septic shock were assigned to 3 groups （midazolam group, propofol group, and dexmedetomidine group ） randomly. The basic characteristics of patients, the duration of mechanical ventilation, the length of stay in the ICU, the death rate for 28 days and the regulatory cell （Treg） in peripheral blood were observed. The control group for Treg test was consisted of 20 healthy volunteers. Results There were no significant differences between the groups in the death rate for 28 days and the duration of mechanical ventilation. The length of stay in the ICU in dexmedetomidine group was shorter than that in midazolam group（ 15.21 ± 5.55 vs. 19. 67 ± 5.7 days, P 〈0. 05）. The Treg of 3 groups was higher than that of control group （11.82 ± 4. 93 vs. 3.69 ± 1.71, 11.30±3.42 vs. 3.69±1.71, 12. 83 ±6.17 vs. 3.69±1.71） at the first day of ICU. The Treg after 3 ICU days in dexmedetomidine group and the Treg after 5 ICU days in propofol group and in midazolam group have no difference with control group. Conclusion For the patients with septic shock, dexmedetomidine could decrease the length of stay in the ICU and the duration of immune suppression.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第22期1758-1761,共4页
National Medical Journal of China
基金
浙江省科技厅公益类项目（2012C33039）
浙江省自然科学基金（LY12H02005）
