右美托咪定与咪达唑仑用于ICU机械通气患者的镇静效果比较
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篇名: 右美托咪定与咪达唑仑用于ICU机械通气患者的镇静效果比较
TITLE:
摘要: 目的:比较右美托咪定与咪达唑仑用于重症医学科(ICU)机械通气患者的镇静效果。方法: 74例ICU收治的患者,按随机数字表法分为右美托咪定组(37例)与咪达唑仑组(37例)。在机械通气治疗的基础上,右美托咪定组患者给予右美托咪定注射液200 μg,溶于0.9%氯化钠注射液48 ml中,先给予负荷剂量1 μg/kg于30 min内泵入完毕,再调整以0.2~0.7 μg/(kg·h)微量泵入;咪达唑仑组患者给予咪达唑仑注射液30 mg,溶于0.9%氯化钠注射液44 ml中,先给予负荷剂量0.05 mg/kg于15 min内泵入完毕,再调整以0.04~0.20 mg/(kg·h) 微量泵入。观察两组患者镇静效果、临床指标(停药后撤机时间、停药后拔管时间、机械通气时间、ICU住院时间)及不良反应发生情况。结果:两组患者镇静效果差异无统计学意义(P>0.05); 右美托咪定组患者停药后撤机时间、停药后拔管时间、ICU住院时间显著短于咪达唑仑组,差异均有统计学意义(P<0.05);右美托咪定组患者总不良反应发生率显著低于咪达唑仑组,差异有统计学意义(P<0.05)。结论:右美托咪定用于ICU机械通气患者镇静效果与咪达唑仑相当,停药后撤机、拔管和ICU住院时间均短于咪达唑仑,且总不良反应发生率低于咪达唑仑。
ABSTRACT: OBJECTIVE: To compare the sedative effects of dexmedetomidine and midazolam in patients with comprehensive ICU mechanical ventilation. METHODS: 74 patients in ICU were randomly divided into dexmedetomidine group (37 cases) and midazolam group (37 cases). Based on mechanical ventilation,dexmedetomidine group received 200 μg Dexmedetomidine injection, dissolving in 48 ml 0.9% Sodium chloride injection, pumped by 1 μg/kg within 30 min, then adjusted to 0.2-0.7 μg/(kg·h) by micropump.  Midazolam group received 30 mg Midazolam injection, dissolving in 44 ml 0.9% Sodium chloride injection, pumped by 0.05 mg/kg within 15 min, then adjusted to 0.04-0.20 mg/(kg·h) by micropump. The sedative effects, clinical indicators (weaning time, extubation time, time of mechanical ventilation, ICU hospitalization time) and the incidence of adverse reactions in 2 groups were observed. RESULTS: There was no significant difference in the sedative effects (P>0.05); weaning time, extubation time, and ICU hospitalization time in dexmedetomidine group were significantly shorter than midazolam group, the differences were statistically significant (P<0.05); the incidence of total adverse reactions in dexmedetomidine group was significantly lower than midazolam group, the difference was statistically significant (P<0.05). CONCLUSIONS: Dexmedetomidine show similar sedative effects with midazolam in patients with comprehensive ICU mechanical ventilation, shorter weaning time, extubation time, ICU hospitalization time, and lower incidence of total adverse reactions than midazolam.
期刊: 2016年第27卷第24期
作者: 吴翔,陶飞,吴晓第,娄侠儒
AUTHORS: WU Xiang,TAO Fei,WU Xiaodi,LOU Xiaru
关键字: 右美托咪定;咪达唑仑;重症医学科;机械通气;镇静
KEYWORDS: Dexmedetomidine; Midazolam; ICU; Mechanical ventilation; Sedation
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