摘要
目的分析盐酸右美托咪定目标浅镇静在ICU病房行机械通气患者中的应用效果。方法将ICU病房的92例机械通气患者随机分为对照组和实验组两组,每组各46例,其中对照组予以常规镇静方案,实验组予以盐酸右美托咪定目标浅镇静方案。通过对比两组镇静指标评价两种镇静方案的优劣。结果实验组舒芬太尼、丙泊酚用量明显少于对照组,组间差异显著(P<0.05);两组目标镇静达成率无显著差异(P>0.05)。实验组相较于对照组,机械通气时间[(114.53±84.63)h vs(168.61±98.32)h]、浅镇静时间[(26.36±8.16)h vs(38.50±6.52)h]、停药后唤醒时间[(0.43±0.16)h vs(0.71±0.23)h]、ICU住院时间[(10.72±5.35)h vs(13.86±8.11)h]均明显减少(t=2.827、7.883、6.778、2.192,P=0.006、0.001、0.001、0.031)。两组患者停药后48h的MMSE评分较用药前均无显著差异(P>0.05),心率、平均动脉压较用药前均显著下降(P<0.05);停药后48h,MMSE评分,心率和平均动脉压组间比较无明显差异(P>0.05)。实验组相较于对照组,谵妄(13.04%vs 36.96%)、躁动(10.87%vs 30.43%)发生率更低(χ2=7.015、5.373,P=0.008、0.020)。结论对于ICU病房实施机械通气的患者而言,盐酸右美托咪定目标浅镇静模式,可获得较为显著的镇静与镇痛作用,还能降低谵妄、躁动等不良事件发生率,具有较高的临床应用价值。
Objective To analyze the clinical effect of dexmedetomidine hydrochloride targeted shallow sedation in ICU patients with mechanical ventilation.Methods 92 mechanically ventilated patients in the ICU ward were randomly divided into two groups:the control group and the experimental group,each with 46 cases.The control group received conventional sedation and the experimental group received dexmedetomidine hydrochloride targeted shallow sedation.The pros and cons of the two sedation programs were evaluated by comparing the two sets of sedation indicators.Results The dosage of sufentanil and propofol in the experimental group was significantly less than that in the control group,and the difference between the groups was significant(P<0.05).There was no significant difference in the target sedation achievement rate between the two groups(P>0.05).Compared with the control group,the experimental group had shorter mechanical ventilation time【(114.5±84.63)h vs(168.6±98.32)h】,shorter light sedation time【(26.3±8.16)h vs(38.5±6.52)h】,shorter waking-up time after drug withdrawal【(0.4±0.16)h vs(0.7±0.23)h】,and shorter ICU stay【(10.7±5.35)h vs(13.8±8.11)h】(t=2.828,7.922,7.262,2.164;P=0.006,0.001,0.001,0.033).There was no significant difference in the MMSE score between the two groups 48 hours after drug stopped(P>0.05),and the heart rate and mean arterial pressure were significantly lower than before(P<0.05).48 hours after drug stopped,there was no significant difference in MMSE score,heart rate and mean arterial pressure within the groups(P>0.05).Compared with the control group,the experimental group had a lower incidence of delirium(13.04%vs 36.96%)and agitation(10.87%vs 30.43%)(χ2=7.015,5.373,P=0.008,0.020).Conclusion For patients who are on mechanical ventilation in the ICU ward,the target shallow sedation mode of dexmedetomidine hydrochloride can obtain more significant sedation and analgesia,and it can also reduce the incidence of delirium,agitation and other adverse events,which is worthy of wide
作者
刘龙娟
王伟
孔重红
LIU Long-juan;WANG Wei;KONG Chong-hong(Anesthesiology Department,Central Hospital of Tongchuan Mining Bureau,Tongchuan,Shaanxi 727000,China;Anesthesiology Department,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230000,China)
出处
《临床肺科杂志》
2021年第10期1525-1529,共5页
Journal of Clinical Pulmonary Medicine
关键词
ICU
机械通气患者
盐酸右美托咪定
目标浅镇静
不良事件
ICU
mechanical ventilation patients
dexmedetomidine hydrochloride
targeted shallow sedation
adverse events
