摘要
目的分析瑞芬太尼复合咪达唑仑应用于急性呼吸窘迫综合征患者中的镇静镇痛效果。方法目的选取2021年8月—2023年7月赤峰市肿瘤医院收治的88例急性呼吸窘迫综合征患者为研究对象。根据镇静镇痛方式不同分为对照组、观察组,各44例。其中对照组采用咪达唑仑镇静镇痛,观察组在对照组的基础上联合瑞芬太尼镇静镇痛。对比两组血流动力学变化、镇静和镇痛效果及不良反应发生情况。结果两组给药前、给药后6 h、给药后24 h和给药后48 h各时刻整体的心率、平均动脉压及血氧饱和度对比,差异均无统计学意义(P均>0.05);但给药后0.5 h观察组患者心率、平均动脉压及血氧饱和度均较对照组更平稳,差异均有统计学意义(P均<0.05)。给药后0.5 h、给药后6 h观察组镇静效果评分为(2.11±0.17)分、(2.42±0.18)分,均低于对照组的(2.32±0.15)分、(2.60±0.21)分,差异均有统计学意义(t=6.144,4.317;P均<0.05);两组给药后24 h和给药后48 h镇静效果评分对比,差异均无统计学意义(P均>0.05)。给药后0.5 h、给药后6 h、给药后24 h和给药后48 h各时刻观察组镇痛效果评分均低于对照组,差异均有统计学意义(P均<0.05)。观察组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。结论在急性呼吸窘迫综合征患者镇静镇痛干预方面,无论是单一采取咪达唑仑还是联合瑞芬太尼都能够达到一定效果,且均具有较高的安全性。但联合用药方案提高镇静镇痛效果的同时,能够进一步稳定患者血流动力学变化,且不会增加风险隐患。
Objective To analyze the sedative and analgesic effect of remifentanil combined with midazolam application in patients with acute respiratory distress syndrome.Methods A total of eighty-eight patients with acute respiratory distress syndrome admitted to Chifeng Cancer Hospital from August 2021 to July 2023 were purposefully selected as the study subjects.According to the different methods of sedation and analgesia,they were divided into control group and observation group,forty-four cases in each group.The control group was treated with midazolam for sedation and analgesia,and the observation group was combined with remifentanil for sedation and analgesia on the basis of the control group.The hemodynamic changes,sedative and analgesic effects and adverse reactions were compared between the two groups.Results There were no significant differences in the overall heart rate,mean arterial pressure and oxygen saturation between the two groups before administration,6 h after administration,24 h after administration and 48 h after administration(all P>0.05).However,the heart rate,mean arterial pressure and blood oxygen saturation of the observation group were more stable than those of the control group at 0.5 h after administration,and the differences were statistically significant(all P<0.05).The sedative effect scores of the observation group at 0.5 h and 6 h after administration were 2.11±0.17 and 2.42±0.18,which were lower than 2.32±0.15 and 2.60±0.21 of the control group,and the differences were statistically significant(t=6.144,4.317;all P<0.05);there were no significant differences in sedation score between the two groups at 24 h and 48 h after administration(all P>0.05).The analgesic effect scores of the observation group were lower than those of the control group at 0.5 h,6 h,24 h and 48 h after administration,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion In terms of sedation and analgesia intervention in patients with acute respiratory distress syndrome,either midazolam alone or combined with remifentanil can achieve a certain effect,and both have high safety.However,the combination regimen can further stabilize the hemodynamic changes of patients while improving the sedative and analgesic effects,and will not increase the risk of hidden dangers.
作者
刘丽
张小艳
乌美茹
LIU Li;ZHANG Xiaoyan;WU Meiru(Department of Critical Care Medicine,Chifeng Cancer Hospital,Chifeng 024000,Inner Mongolia Autonomous Region,China)
出处
《系统医学》
2025年第14期52-56,共5页
Systems Medicine
