摘要
目的对ICU机械通气患者分别行丙泊酚、右美托咪定、咪达唑仑镇静的效果进行比较分析。方法将医院2018年5月~2019年4月收治全身麻醉术后继续行机械通气呼吸支持治疗的72例患者作为研究对象,应用分层随机方法将患者分为三组,均24例。三组患者在机械通气的同时,分别应用丙泊酚、右美托咪定、咪达唑仑进行麻醉镇静。对三组患者的镇静效果、不良反应等指标进行统计分析与比较。结果右美托咪定组的镇静深度满意时间、停药后苏醒时间、不良反应发生率要低于其他两组,但统计学比较并无明显差异(P>0.05)。三组患者随着镇静程度的加深BIS值逐渐下降,且右美托咪定组在不同镇静深度的BIS值更低于其他两组(P<0.05)。ROC曲线分析显示,在适度镇静状态下,右美托咪定组的BIS临界值明显低于其他两组。结论在ICU机械通气患者的镇静用药中,右美托咪的总体镇静效果及安全性更高,可以作为优先选择。
Objective To compare the effect of propofol, dexmedetomidine and midazolam in ICU mechanical ventilation patients. Methods The clinical data of 72 patients who continued mechanical ventilation after general anesthesia in ICU from May 2018 to April 2019 were collected, and the patients were divided into three groups of 24 patients by stratified random method. At the same time of mechanical ventilation, they were treated with propofol, dexmedetomidine and midazolam for anesthesia and sedation. The sedative effects and adverse reactions of the three groups were statistically analyzed and compared. Results Compared with the propofol group and the midazolam group, the sedative satisfaction time, recovery time after drug withdrawal and adverse reactions were shorter in the dexmedetomidine group, but there was no statistical difference among the three groups(P>0.05). The BIS values of the three groups gradually decreased with the degree of sedation, and the BIS values of the dexmedetomidine group were lower than the other two groups(P<0.05). ROC curve analysis showed that the BIS threshold was significantly lower in the dexmedetomidine group than in the other two groups under moderate sedation. Conclusion In the sedative of ICU mechanically ventilated patients, dexmedetomidine has a higher overall sedative effect and safety, which is considered to be preferred.
作者
段榆琳
王宋平
DUAN Yu-lin;WANG Song-ping(Department of Critical Care Medicine,the First People’s Hospital of Neijiang,Neijiang,Sichuan 641000,China;Department of Respiratory Medicine,the First People’s Hospital Affiliated to Southwest Medical University,Luzhou,Sichuan 646000,China)
出处
《临床肺科杂志》
2020年第8期1171-1174,共4页
Journal of Clinical Pulmonary Medicine
基金
四川省医学会科研课题(No:12335)。
关键词
机械通气
丙泊酚
右美托咪定
咪达唑仑
镇静
mechanical ventilation
propofol
dexmedetomidine
midazolam
sedation