摘要
目的探讨右美托咪定对神经外科术后患者镇静治疗的应用价值。方法以清远市人民医院2011年9月-2012年9月间,收治的神经外科术后130例患者为研究对象,随机将患者分为A组和B组。其中A组采用右美托咪定镇静,B组采用传统的咪达唑仑镇静。比较两组患者ICU拔管时间、意外拔管率、NICU停留时间、镇痛降压药物的剂量等指标。结果 A组患者的拔管时间较B组短([16.4±15.6)hvs(22.5±18.5)h,P=0.04],A组应用的镇痛药物剂量比B组减少([0.6±0.2)mg/dvs(0.8±0.3)mg,P<0.01],降压药物剂量减少[(116.6±84.3)mgvs(146.9±85.3)mg,P=0.04]。A组患者镇静状态的神志更接近停药后水平(P<0.01)。但两组在NICU生存率、意外拔管几率、呼吸机相关肺炎发生率、NICU停留时间等方面,未见显著差异。结论右美托咪定可有效应用于神经外科术后的镇静治疗,有利于减少拔管时间,减少镇痛药物及降压药物剂量,对患者的神志判断影响相对较小。
Objective To explore the use of dexmetomidine in the sedation treatment after neurological surgery in the neurological intensive care unit（NICU）.Methods During September of 2011 to September of 2012,120 patients after neurological surgerys who the Qingyuan NCIU conducted were enrolled in the research.They were divided into two groups randomly.Group A included the patients who accepted the Dexmedetomidine as sedation treatment,and group B accepted the traditional midazolam.The time of tracheal intubation drawing,the incidence of unexpected tube drawing,the stay-time of NICU,the doses of analgesic and hypotensor were compared as the measurements.Results The time of the tracheal intubation drawing was shorter in group A（[16.4±15.6）h vs（22.5±18.5） h,P=0.04].Less analgesic and hypotensor were needed in group A（0.6±0.2）mg/d vs（0.8±0.3）mg,P0.01 and（116.6±84.3） mg vs（146.9±85.3） mg（P=0.04）.The patients in group A had better status of consciousness which were more likely approaching to the status without sedation treatment.But there was no significant statistical difference in the aspect of survival rate in NICU,the incidence of unexpected tube drawing,the rate of ventilator-associated pneumonia,the stay-time of NICU between two groups.Conclusion Dexmedetomidine could apply to the sedation treatment after neurological surgery effectively.That drug may associated with less time of the tracheal intubation drawing,less need of analgesic and hypotensor and smaller influence on the status of consciousness.[
出处
《当代医学》
2013年第22期3-5,共3页
Contemporary Medicine
关键词
右美托咪定
镇静
神经外科
术后
重症监护
Dexmedetomidine
Sedation
Neurological surgery
Postoperative
Intensive care
