摘要
目的采用右美托咪啶持续静脉泵入联合氟哌啶醇肌内注射对百草枯中毒呼吸衰竭需机械通气患者镇静治疗提供一个优选方案。方法治疗组患者采取氟哌啶醇5 mg肌内注射,1次/d,同时给予右美托咪啶以1μg/kg缓慢静脉注射>10 min,然后以0.2~1.0μg·kg^-1·h^-1持续静脉泵入,根据镇静状态调整用药剂量。对照组应用咪达唑仑2~3 mg静脉注射,随后以0.02~0.10 mg·kg^-1·h^-1持续静脉泵入,同时瑞芬太尼0.2~0.5μg·kg^-1·h^-1持续静脉泵入治疗,根据镇静状态调整用药剂量。结果治疗组和对照组患者镇静效果、有效性相似。治疗组患者每日唤醒评价、机械通气、出现谵妄不良反应均优于对照组,差异有统计学意义(P<0.05)。结论选择右美托咪定联合氟哌啶醇对百草枯中毒呼吸衰竭需机械通气治疗的患者镇静治疗效果好,每日唤醒评价效果优于咪达唑仑、瑞芬太尼镇静,出现谵妄不良反应减少,机械通气时间、VAP发生率减少,也是ICU患者镇静治疗的一个优选方案。
Objective To provide an optimal method for sedation in patients with respiratory failure due to paraquat poisoning.Methods The patients in treatment group were treated by intramuscular injection with haloperidol 5mg,once a day,at the same time,were treated b y slow intravenous injection with dexmedetomidine 1μg/kg for more than 10 minutes,then were treated by continuous intravenous infusion at 0.21μg·kg^-1·h^-1.The dosage was adjusted according to the condition.However the patients in control group were injected intravenously with midazolam 2~3mg,then by continuous intravenous infusion at 0.02~0.10mg·kg^-1·h^-1,and were given remifentanil 0.2~0.5μg·kg^-1·h^-1 by intravenous injection,and the dosage was adjusted according to the condition.Results The sedative effects and effectiveness in both groups were similar.The daily awakening evaluation,mechanical ventilation,and side effects of the patients in treatment group were superior to those in control group(P<0.05).Conclusion Dexmedetomidine combined with haloperidol is effective in treating the patients with respiratory failure due to paraquat poisoning,with better daily awakening evaluation than midazolam and remifentanil,less adverse effect,less mechanical ventilationg time and reduced VAP incidence.It is a preferred plan for sedation treatment of patients in ICU.
作者
张晓博
许运铎
陈凤兰
鲍倩
耿丽华
白雪景
张桂英
ZHANG Xiaobo;XU Yunduo;CHEN Fenglan(The Fourth People’s Hospital of Hengshui City,Hebei,Hengshui 053000,China)
出处
《河北医药》
CAS
2019年第23期3592-3594,3598,共4页
Hebei Medical Journal
关键词
右美托咪定联合氟哌啶醇
镇静治疗
百草枯中毒
呼吸衰竭
呼吸机相关性肺炎
dexmedetomidine combined with haloperidol
sedation therapy
paraquat poisoning
respiratory failure
ventilator-associated pneumonia
