舒芬太尼联合右美托咪定在ICU机械通气患者中的临床应用价值

摘要

ObjectiveTo compare the analgesic and sedative effect of sulfentanyl combined with dexme-detomidine and sulfentanyl combined with midazolam on patients with mechanical ventilation in ICU.Method 60 patients in our hospital from 2013 to 2014 treated with mechanical ventilation in ICU were randomly divided into two groups, group A (sulfentanyl combined with dexmedetomidine) and group B (sulfentanyl combined with midazolam), each group contained 30 cases, the sedative and analgesic effects and untoward reactions were compared between the two groups.ResultThere was no significant difference in sedative effect between group A and group B (P>0.05), but the analgesic effect was superior than group B (P<0.05), Group A of patients with probability of delirium and untoward reaction rate were signiifcantly lower than group B (P<0.05). After treatment at each time point and after extubation, the HR, SpO2 and MAP changes in group A compared with group B were signiifcantly different (P<0.05).ConclusionSulfentanyl combined with dexmedetomidine can be safely used for ICU patients with mechanical ventilation, less untoward reaction, worthy of clinical promotion.%目的：比较舒芬太尼联合右美托咪定和舒芬太尼联合咪达唑仑对ICU机械通气患者镇静、镇痛的效果。方法将2013～2014年本院收治的ICU机械通气危重患者60例随机分为A组（舒芬太尼联合右美托咪定）与B组（舒芬太尼联合咪达唑仑），每组各30例，比较两组患者的镇静、镇痛效果及谵妄等不良反应发生率。结果 A组患者镇静效果与B组比较无明显差异（P＞0.05），但镇痛效果优于B组（P＜0.05）。A组患者谵妄等不良反应发生率明显低于B组（P＜0.05）。A组患者用药后各时间点及拔管后心率、脉博血氧饱和度及平均动脉压变化与B组比较均具有显著差异（P＜0.05）。结论舒芬太尼联合右美托咪定对ICU机械通气患者的镇痛、镇静效果确切，作用更强，不良反应少，值得临床推广。