摘要
目的:探讨苯磺酸瑞马唑仑对重症监护室(ICU)机械通气患者血流动力学及呼吸功能的影响。方法:选取2020年1月~2022年12月期间某院收治的90例ICU机械通气患者作为研究对象,采用随机数字表法分为对照组和观察组,每组45例。所有患者均持续静脉泵入枸橼酸舒芬太尼注射液,对照组患者给予咪达唑仑注射液镇静,观察组患者给予注射用苯磺酸瑞马唑仑镇静。比较两组患者临床指标(通气时间、拔管时间、ICU时间、住院时间、舒芬太尼用量)、不同时间点[用药前(T_(0))、用药后30 min(T_(1))、用药后6 h(T_(2))、用药后24 h(T_(3))、拔管时(T_(4))]血流动力学指标[心率(HR)、平均动脉压(MAP)]、呼吸功能指标[呼吸频率(RR)、血氧饱和度(SpO_(2))]、肝肾功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(Cr)和血尿素氮(BUN)]及不良反应发生情况。结果:观察组患者通气时间、拔管时间、ICU时间和住院时间均短于对照组(P<0.05),舒芬太尼用量低于对照组(P<0.05)。观察组患者T_(1)、T_(2)、T_(3)、T_(4)时MAP和HR均高于对照组(P<0.05)。两组患者各时间点RR和SpO_(2)比较均无统计学差异(P>0.05)。观察组患者用药后48 h血清ALT、AST、Cr和BUN水平均低于对照组(P<0.05)。两组患者心动过缓和低血压的发生率比较均无统计学差异(P>0.05);观察组患者谵妄、呼吸抑制的发生率和不良反应总发生率均低于对照组(P<0.05)。结论:苯磺酸瑞马唑仑用于ICU机械通气患者的镇静效果良好,可维持血流动力学稳定,对患者肝肾功能影响较小,且不增加不良事件的发生风险。
Objective:To investigate the effects of remimazolam besylate on hemodynamics and respiratory function in patients with mechanical ventilation in intensive care unit(ICU).Methods:A total of 90 ICU patients receiving mechanical ventilation admitted to a hospital between January 2020 and December 2022 were selected and divided into the control group and the observation group using random number table method,with 45 patients in each group.All patients were continuously intravenously pumped with sufentanil citrate injection,the control group was treated with midazolam injection for sedation,while the observation group was treated with remimazolam besylate for injection for sedation.Clinical indexes(ventilation duration,time to extubation,ICU stay,hospitalization stay,sufentanil dosage),hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP)],respiratory function indexes[respiratory rate(RR)and blood oxygen saturation(SpO_(2))]at different time points[pre-dose(T_(0)),30 min post-dose(T_(1)),6 h post-dose(T_(2)),24 h post-dose(T_(3))at extubation(T_(4))],liver and kidney function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr)and blood urea nitrogen(BUN)]and adverse reactions were compared between the two groups.Results:The ventilation duration,time to extubation,ICU stay and hospitalization stay in the observation group were shorter than those in the control group(P<0.05).The sufentanil dosage in the observation group was lower than that in the control group(P<0.05).The MAP and HR at T_(1),T_(2),T_(3) and T_(4) in the observation group were higher than those in the control group(P<0.05).There was no statistically significant difference in RR and SpO_(2) between the two groups at each time point(P>0.05).The levels of serum ALT,AST,Cr and BUN in the observation group were lower than those in the control group at 48 h post-dose(P<0.05).There was no statistically significant difference in the incidence of bradycardia and hypotension between the two groups(P>0.05).The incidences of delirium,respiratory depression and total incidence of adverse reactions in the observation group were lower than those in the control group(P<0.05).Conclusion:Remimazolam besylate has good sedative effect in ICU patients with mechanical ventilation,and can maintain stable hemodynamics with minimal effect on liver and kidney function,without increasing the risk of adverse events.
作者
刘良丽
管胜伟
范迎娜
LIU Liang-li;GUAN Sheng-wei;FANG Ying-na(Department of Intensive Medicine,Zhoukou Hospital of Traditional Chinese Medicine,Zhoukou 466000,China)
出处
《中国合理用药探索》
2025年第5期117-122,共6页
Chinese Journal of Rational Drug Use
基金
河南省二〇二二年科技发展计划项目(222102310251)。
关键词
苯磺酸瑞马唑仑
机械通气
重症监护室
血流动力学
镇静
remimazolam besylate
mechanical ventilation
intensive care unit
hemodynamics
sedation
