摘要
目的比较右美托咪定与丙泊酚对连枷胸合并肺损伤患者镇静的临床效果。方法选择潍坊市人民医院重症医学科(ICU)2010年9月—2011年8月连枷胸合并肺损伤需要行机械通气的患者30例,随机分为右美托咪定组和丙泊酚组,各15例。右美托咪定组:给予右美托咪定负荷量1μg.kg-1.d-1经静脉泵注射20min,维持剂量0.2～0.7μg.kg-1.d-1支持。丙泊酚组:首先静脉注射1mg/kg丙泊酚进行镇静诱导,维持剂量为0.5～4.0 mg.kg-1.h-1。比较两组患者的心率、平均动脉压(MAP)、芬太尼使用剂量、脱机时间,住ICU时间。结果右美托咪定组在治疗后6、24h时的心率和MAP与丙泊酚组比较,差异均有统计学意义(P<0.05);两组患者在48h的心率和MAP比较,差异无统计学意义(P>0.05)。两组患者脱机时间、住ICU时间和芬太尼使用剂量比较,差异均有统计学意义(P<0.05)。结论右美托咪定应用于连枷胸合并急性肺损伤患者镇静安全、有效,能减少降压药物及芬太尼的用量,并能缩短机械通气时间及住ICU时间。
Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol for sedation of flail chest complicated with acute pulmonary contusion patients in intensive care unit.Methods Thirty flail chest complicated with acute pulmonary contusion patients were admitted to our ICU from September 2010 to August 2011 and treated by ventilatory support;they were randomly divided into two groups to receive either dexmedetomidine or propofol.The dexmedetomidine group：received a loading dose of 1μg·kg-1·d-1for 20 min,followed by continuous infusion at 0.2~0.7μg·kg-1·d-1.The propofol group：received a loading dose of 1mg/kg,followed by continuous infusion at 0.5~4.0 mg·kg-1·d-1.The heart rate,blood pressure,fentanyl dosage,the Mechanical ventilation time and duration in ICU were compared between the 2 groups.Results Dexmedetomidine group during the treatment and after 6,24 h rate and MAP and propofol group,the differences were statistically significant（P0.05）.Two groups of patients offline time,ICU time and dose fentanyl use comparison,the differences were statistically significant（P〈0.05）.Conclusion Dexmedetomidine is safe and effective for the sedation of flail chest complicated with acute pulmonary contusion patients patients,which can reduce the demand for fentanyl,and shorten mechanical ventilation time and the duration of ICU stay.
出处
《实用心脑肺血管病杂志》
2012年第11期1772-1773,共2页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
