摘要
目的探究咪达唑仑联合瑞芬太尼对纤维支气管镜引导下气管插管患者血流动力学及镇静效果的影响。方法选取行纤维支气管镜引导下气管插管患者80例,以随机数字表法分为观察组和对照组,每组40例。对照组患者静脉注射咪达唑仑注射液镇静;在对照组基础上,观察组在咪达唑仑给药2 min后,联合泵注注射用盐酸瑞芬太尼镇静。对比两组患者血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))]、镇静效果、不良反应发生情况。结果观察组术中(T1)、术后30 min(T2)时HR分别为(80.05±1.10)、(81.23±3.09)次/min,MAP分别为(100.06±8.47)、(103.99±8.02)mm Hg(1 mm Hg=0.133 kPa),均低于对照组的(85.34±2.19)、(83.93±4.02)次/min以及(112.78±9.49)、(107.88±8.07)mm Hg;SpO_(2)分别为(96.24±1.23)%、(95.51±1.46)%,均高于对照组的(94.21±1.04)%、(92.26±1.33)%(P<0.05)。插管5 min后,两组Ramsay镇静评分均高于本组插管前,且观察组Ramsay镇静评分(3.81±0.62)分高于对照组的(2.52±0.54)分(P<0.05)。两组不良反应发生率对比差异无统计学意义(P>0.05)。结论咪达唑仑联合瑞芬太尼应用于纤维支气管镜引导下气管插管患者,可有效稳定患者血流动力学指标,提高镇静效果,且不增加不良反应发生率。
Objective To investigate the hemodynamic effects and sedation efficacy of midazolam combined with remifentanil in patients undergoing fiberoptic bronchoscopy-guided tracheal intubation.Methods A total of 80 patients undergoing fiberoptic bronchoscopy-guided tracheal intubation were enrolled.Patients were divided into the observation group and the control group using a randomized number table method,each with 40 cases.Patients in the control group received intravenous midazolam injection for sedation.In the observation group,following midazolam administration,remifentanil hydrochloride for injection was co-administered via infusion pump for sedation 2 min later.Hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO_(2))],sedation effectiveness,and adverse reactions were compared between the two groups.Results In the observation group,the HR during the operation(T1)and 30 min after the operation(T2)were(80.05±1.10)and(81.23±3.09)beats/min,and the MAP were(100.06±8.47)and(103.99±8.02)mm Hg(1 mm Hg=0.133 kPa),which were lower than those in the control group[(85.34±2.19),(83.93±4.02)beats/min and(112.78±9.49),(107.88±8.07)mm Hg];the SpO_(2) were(96.24±1.23)%and(95.51±1.46)%,which were higher than those in the control group[(94.21±1.04)%and(92.26±1.33)%](P<0.05).5 min after intubation,the Ramsay sedation score in both groups was higher than that before intubation in this group.Moreover,the Ramsay sedation scores(3.81±0.62)points in the observation group were higher than the control group's(2.52±0.54)points(P<0.05).No statistically significant differences were observed in incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of midazolam and remifentanil effectively stabilizes hemodynamic indicators,enhances sedation efficacy,and will not increase the incidence of adverse reactions in patients undergoing fiberoptic bronchoscopy-guided tracheal intubation.
作者
韩文洲
HAN Wen-zhou(Department of Critical Care Medicine for Infectious Disease,Guiyang Public Health Treatment Center,Guiyang 550000,China)
出处
《中国现代药物应用》
2026年第3期86-89,共4页
Chinese Journal of Modern Drug Application
