摘要
目的观察布托啡诺与地佐辛分别联合右美托咪定用于无创正压通气患者的镇静镇痛效果异同。方法将88例无创正压通气患者按随机数字表法分为A、B两组。A组给予右美托咪定0.1~0.2μg·kg-1·h-1静脉输注,同时给予布托啡诺以0.01μg·kg-1·h-1静脉输注;B组给予右美托咪定0.1~0.2μg·kg-1·h-1静脉输注,地佐辛0.1 mg/kg静脉注射后再持续静脉泵入0.01~0.04 mg·kg-1·h-1。观察两组患者治疗前后重症监护疼痛观察量表(CPOT)疼痛评分、Ramsay镇静评分、心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、动脉血氧分压(PaO2)、血氧饱和度(SpO2)的变化,记录气管插管率、不良事件发生率。结果两组HR、RR、MAP水平均较治疗前明显降低(t分别=10.34、12.14、14.86、4.81、8.95、7.07,P均<0.05),PaO2、SpO2较治疗前明显升高(t分别=23.11、20.06、24.39、13.27,P均<0.05)。A组治疗后HR、MAP、RR指标低于B组治疗后,PaO2、SpO2指标高于B组治疗后,差异均有统计学意义(t分别=5.05、5.40、7.32、2.17、6.55,P均<0.05)。两组治疗后CPOT、Ramsay评分均较治疗前明显改善(t分别=15.24、24.16、8.82、30.85,P均<0.05),A组治疗后CPOT评分优于B组,且A组达到Ramsay评分3~4分的起效时间较B组明显缩短,差异均有统计学意义(t分别=5.87、9.75,P均<0.05)。A组患者气管插管率、不良反应发生率低于B组(χ2分别=17.52、20.02,P均<0.05)。结论布托啡诺与右美托咪定联合用药可提高无创正压通气患者通气质量,同时减少不良反应,改善患者预后。
Objective To compare the sedative and analgesic effects of butorphanol and dizocine combined with dexmedetomidine respectively in patients with noninvasive positive pressure ventilation. Methods A total of 88 cases with non-invasive positive pressure ventilation were randomly divided into group A and group B.Patients in group A were intravenously infused dexmedetomidine in speed of 0.1～0.2μg·kg^-1·h^-1 and butorphanol with a speed of 0.01μg·kg^-1·h^-1.Patients in group B were intravenously infused dexmedetomidine in speed of 0.1～ 0.2μg·kg^-1·h^-1 and tosoxin with a dose of 0.1 mg/kg,and then intravenously infused tosoxin in speed of 0.01～0.04 mg·kg^-1·h^-1.The Ramsay sedation score,CPOT score,heart rate（HR）,respiratory rate（RR）,mean arterial pressure（MAP）,arterial oxygen partial pressure （PaO2）,and saturation of pulse oxygen（SpO2）were measured before and after treatment in the two groups.The rate of tracheal intubation and the incidence of adverse events were recorded.Results The levels of HR,MAP,and RR after treatment in the two groups were significantly lower than those before treatment（t=10.34,12.14,14.86,4.81,8.95,7.07,P〈0.05）,while the PaO2 and SpO2 were significantly higher than before treatment（t=23.11,20.06,24.39,13.27,P〈0.05）.The HR,MAP,RR after treatment of group A were significantly lower than those of group B,and the PaO2,SpO2 were significantly higher than those of the group B（t=5.05,5.40,7.32,2.17,6.55,P〈0.05）.After treatment,the Ramsay score and CPOT of the two groups were significantly improved（t=15.24,24.16,8.82,30.85,P〈0.05）.The CPOT score pf group A was significantly lower than that of group B,the onset time that Ramsay score reached to 3 or 4 points of group A was significantly shorter than group B（t=5.87,9.75,P〈0.05）.The incidence of tracheal intubation and adverse reactions of group A were lower than those of group B（χ^2=17.52,20.02,P〈0.05）.Conclusion Butorphanol combined with dexmedetomidine could improve the ventilat
作者
莫路姣
沈晓圆
潘萍
许冠华
俞林峰
曹力佳
董洪亮
沈建军
王云超
MO Lujiao;SHEN Xiaoyuan;PAN ping(Intensive Care Unit,NO.1 Hospital of Xiaoshan,Hangzhou 311201,China)
出处
《全科医学临床与教育》
2018年第6期655-658,共4页
Clinical Education of General Practice
关键词
布托啡诺
地佐辛
无创正压通气
镇静
镇痛
butorphanol
dezocine
noninvasive positive pressure ventilation
sedation
analgesia
