摘要
目的观察不同剂量布托啡诺联合右美托咪定在重型颅脑损伤患者中的应用效果,为临床治疗提供依据。方法选取2019年1月至2020年8月郑州大学第一附属医院神经重症监护病房(NCU)收治的120例重型颅脑损伤患者,按照随机数表法分为A组、B组和C组,每组40例。给予A组8 mg布托啡诺+右美托咪定,给予B组12 mg布托啡诺+右美托咪定,给予C组16 mg布托啡诺+右美托咪定。观察并记录用药后6、12、24 h患者血流动力学指标[心率(HR)、经皮动脉血氧饱和度(SpO 2)、平均动脉压(MAP)]、重症疼痛观察工具(CPOT)评分、Richmond躁动-镇静评分量表(RASS)评分以及用药后3、7、14 d格拉斯哥昏迷量表(GCS)评分、机械通气时间、NCU住院时间及不良反应发生情况。结果同组用药后6、12、24 h HR和MAP水平均较用药前降低(P<0.05),同一时间点各组HR、SpO 2、MAP水平比较,差异无统计学意义(P>0.05)。3组用药后6、12、24 h CPOT评分均为0~3分,RASS评分均为-2~1分,均可达到理想的镇痛镇静状态,同一时间点各组CPOT、RASS评分比较,差异无统计学意义(P>0.05)。与用药前相比,3组用药后GCS评分均呈升高趋势,且A组和B组用药后同一时间点GCS评分均高于C组(P<0.05)。A组、B组机械通气时间、NCU住院时间均短于C组(P<0.05)。A组和B组机械通气时间、NCU住院时间比较,差异无统计学意义(P>0.05)。镇痛镇静治疗期间A组、B组不良反应发生率均低于C组(P<0.05)。结论布托啡诺剂量为8、12 mg时对重型颅脑损伤患者镇痛镇静效果较好,机械通气时间及NCU住院时间较短,不良反应发生率较低,值得临床推广应用。
Objective To observe the application effects of different doses of butorphanol combined with dexmedetomidine in patients with severe head injury,so as to provide a basis for clinical treatment.Methods A total of 120 patients with severe head injury admitted to Neurological Intensive Care Unit(NCU),the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2020 were divided into group A,group B and group C according to random number table,and there were 40 cases in each group.Group A was given 8 mg butorphanol combined with dexmedetomidine,and group B was given 12 mg butorphanol combined with dexmedetomidine,and group C was given 16 mg butorphanol combined with dexmedetomidine.The hemodynamic indexes[heart rate(HR),percutaneous arterial oxygen saturation(SpO 2)and mean arterial pressure(MAP)],critical-care pain observation tool(CPOT)scores,Richmond agitation-sedation scale(RASS)scores at 6,12 and 24 hours after medication,Glasgow coma scale(GCS)scores on 3,7 and 14 days after medication,duration of mechanical ventilation,length of stay in NCU and occurrence of adverse reactions were observed and recorded.Results The HR and MAP levels of the same group at 6,12 and 24 hours after medication were all lower than those before medication(P<0.05),and there were no statistical differences in HR,SpO 2 and MAP levels among the three groups at the same time point(P>0.05).The CPOT scores of the three groups at 6,12 and 24 hours after medication were all 0 to 3,and the RASS scores were all-2 to 1,and they all reached the ideal analgesic and sedative state,and there were no statistical differences in CPOT scores and RASS scores among the three groups at the same time(P>0.05).The GCS scores of the three groups after medication were all higher than those before medication,and the GCS scores of group A and group B after medication were all higher than those of group C at the same time(P<0.05).The duration of mechanical ventilation,length of stay in NCU of group A and group B were all shorter than those of gr
作者
周巧玉
刘悦
高林
ZHOU Qiaoyu;LIU Yue;GAO Lin(Neurological Intensive Care Unit,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2021年第7期1178-1181,共4页
Henan Medical Research
基金
河南省医学科技攻关计划项目(2018020054)。
关键词
重型颅脑损伤
布托啡诺
右美托咪定
镇痛镇静
severe head injury
butorphanol
dexmedetomidine
analgesia and sedation
