右美托咪定與咪達唑侖在機械通氣重癥患者鎮(zhèn)靜中的效果比較

鐘盛華 鄢志磊 吳樂峰 危雪暉

[關(guān)鍵詞] 右美托咪定;咪達唑侖;機械通氣;重癥;鎮(zhèn)靜;血流動力學(xué)

[中圖分類號] R614? ? ? ? ? [文獻標(biāo)識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）25-0035-04

Comparison of the effects of dexmedetomidine and midazolam in the sedation of severely ill patients with mechanical ventilation

ZHONG Shenghua1? ?YAN Zhilei1? ?WU Lefeng1? ?WEI Xuehui2

1.Department of Critical Care Medicine， Fuzhou First People's Hospital in Jiangxi Province， Fuzhou? ?344000， China; 2.Department of Clinical Pharmacy， Fuzhou First People′s Hospital in Jiangxi Province， Fuzhou? ?344000， China

[Abstract] Objective To explore the value of dexmedetomidine and midazolam for sedation in severely ill patients with mechanical ventilation. Methods From January 2019 to December 2020， 90 mechanically ventilated critically ill patients admitted to Fuzhou First People′s Hospital were selected as the research objects. They were divided into the observation group and the control group according to a 1：1 ratio， with 45 cases in each group. The observation group was sedated with dexmedetomidine， and the control group was sedated with midazolam. The sedative effect， analgesic effect， hemodynamic changes， and the incidence of adverse reactions were compared between the two groups. Results ①Sedation effect： the observation group′s sedation score （-4.21±0.21） points， wake-up time after stopping the drug （0.18±0.02） h， mechanical ventilation time （3.31±1.05） d were shorter than those of the control group， and the difference was statistically significant （P<0.05）. The time to reach the target sedation level （0.25±0.06） h in the observation group was no different from the control group. ②Analgesic effect： The VAS score （2.31±0.91） of the observation group was lower than that of the control group， and the difference was statistically significant （P<0.05）. ③Changes in hemodynamics： The heart rate， systolic blood pressure， diastolic blood pressure， and respiration of the observation group during T1， T2， T3， and T4 were higher than those of the control group， and the difference was statistically significant （P<0.05）. ④The incidence of adverse reactions of the observation group （4.44%） was lower than the control group （22.22%）， and the difference was statistically significant （P<0.05）. Conclusion Dexmedetomidine in sedation of severely ill patients with mechanical ventilation has a significant effect. It can improve the patient′s sedative and analgesic effect， improve the changes in hemodynamics， and avoid fluctuations in blood pressure and heart rate， which greatly affect the sedative effect. And it is worth learning.