摘要
目的探讨咪达唑仑联合芬太尼用于危重患者机械通气时镇静、镇痛时的疗效和安全性。方法将2014年12月~2016年12月我院拟行机械通气的122例危重患者随机分为实验组和对照组,各61例。对照组应用咪达唑仑进行插管前镇静治疗,实验组在此基础上联合芬太尼进行插管前镇静、镇痛治疗。比较两组药物起效时间、苏醒时间、患者痛苦程度、机械通气24 h后两组患者血压、心率、呼吸频率、Sp O2、Sp O2/Fi O2以及术中不良反应。结果实验组患者药物起效时间[(49.3±8.7)s]、苏醒时间[(20.2±6.2)min]均短于对照组[(85.6±12.7)s、(39.2±8.9)min],BPS评分[(2.4±1.0)分]低于对照组[(5.2±2.4)分];机械通气24 h后,实验组心率[(75.3±6.6)次/min]、呼吸频率[(14.2±3.5)次/min]低于对照组[(84.1±7.8)、(18.8±4.1)次/min],Sp O2[(97.1±2.5)%]、Sp O2/Fi O2[(256.4±25.6)mm Hg]高于对照组[(92.2±3.3)%、(209.8±30.8)mm Hg],实验组不良反应总发生率(21.31%)低于对照组(61.85%),差异均有统计学意义(P<0.05)。结论咪达唑仑联合芬太尼用于危重患者机械通气时镇静、镇痛时的起效时间短、苏醒快,明显减轻患者的痛苦,对呼吸、循环系统的影响较小,值得推广。
Objective To explore the Efficency and safety of Midazolam combined with Fentanyl in sedation and analgesia of critically severe patients with mechanical ventilation.Methods 122 cases of severe patients undergoing mechanical ventilation in our hospital from December 2014 to December 2016 were selected and divided into experimental group and control group,with 61eases in each group.The control group was used Midazolam for sedation before intubation.The experimental group was used Fentanyl on the basis of control group.The onset time,wake up time,the degree of patient distress and 24 h after mechanical ventilation,the blood pressure,heart rate,RP,SpO2,SpO2/FiO2 of patients and were compared between two groups.Results The onset time and wake up time[（49.3±8.7）s,（20.2±6.2）min] in experimental group were shorter than those in control group [（85.6±12.7）s,（39.2±8.9）min],the BPS score of experimental group [（2.4±1.0） points] was lower than that in control group[（5.2±2.4） points],the levels of heart rate and PR [（75.3±6.6）,（14.2± 3.5） times/mini of patient in experimental group were lower than those in control group[（84.1±7.8）,（18.8±4.1） times/mini, the SpO2,SpO2/FiO2 in experimental group [（97.1±2.5）%,（256.4±25.6）mmHg] were higher than those in control group [（92.2±3.3）%,（209.8±30.8）mmHg],the total incidence of adverse reaction in experimental group（21.31%） was lower than that in control group（61.85%）.All the differences were statistically significant （P〈0.05）.Conclusion Midazolam combined with Fentanyl in mechanical ventilation sedation and analgesia of critically ill patients with advantages of short onset time,fast wake up,significantly reducing the pain of patients,and has less affect on heart rate and respiratory rate.h is worthy to popularize.
出处
《中国当代医药》
2017年第12期90-92,共3页
China Modern Medicine
基金
广东省东莞市科技计划医疗卫生类科研一般项目(201310515000352)
关键词
咪达唑仑
芬太尼
机械通气
Midazolam
Fentanyl
Mechanical ventilation
