目的：探讨咪达唑仑-舒芬太尼在机械通气治疗多发肋骨骨折患者的中镇痛镇静效果。方法：18例接受机械通气患者均予首剂静脉注射咪达唑仑0.15～0.3mg／kg、舒芬太尼1～2µg／kg镇痛镇静负荷量,后予咪达唑仑0.05～0.1mg／kg/h、舒芬太尼0.3～1.5µg/kg/h微泵注射维持,根据患者情况个体化调整入量,维持镇静Ramsay评分在3～4分水平,通过监测患者心率、呼吸、平均动脉压及动脉血气分析进行治疗前后对比评估。结果：在负荷剂量及维持量下所有患者均能够达到目标镇痛镇静效果,Ramsay评分均在3～4分。患者用药1h后HR、RR、SaO2,平均动脉压及动脉血气pH值、PaO2、PaCO2均较用药前明显改善(P<0.01)。结论：对ICU机械通气治疗多发性肋骨骨折的患者,咪达唑仑-舒芬太尼能显著提高患者的镇痛镇静效果,避免“人-机对抗”,改善氧合,降低耗氧,效果确切。%Objective:To investigate the effects of midazolam-sufentanil during mechanical ventilation in the treatment of multiple ribs fracture patients in sedation and analgesia effect.Methods:18 cases of patients receiving mechanical ventilation to the first dose of intravenous midazolam 0.15~0.3mg/kg, with 1 to 2 µ g/kg of analgesic and sedation of load, then with midazolam 0.05~0.1mg/kg/h, with 0.3 to 1.5 µ g/kg/h micropump injection maintenance, according to patients condition a the amount of adjustment, maintain calm Ramsay score in the 3 to 4 level, heart rate, breathing through the monitoring of patients, mean arterial pressure and arterial blood gas analysis were compared before and after treatment to evaluate.Results: In the loading dose and maintenance dose of all patients were able to reach the goals of sedation and analgesia effect, Ramsay score was 3~4.Drug use in patients after 1h HR, RR, SaO2, mean arterial pressure and arterial blood gas pH, PaO2, PaCO2 were obviously improved than before treatment (P<0.01).Conclusion: ICU of mechanical ventilation in the treatment of multiple ribs fracture patients, midazolam - sufentanil can significantly improve patient sedation and analgesia effect, avoid“man machine confrontation”, improve oxygenation, reduce oxygen consumption, the exact effect.
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