丙泊酚在ICU老年患者创伤后精神障碍中的应用

Effect of propofol on elderly post traumatic patients with mental confusion in ICU

目的探讨丙泊酚治疗ICU老年患者创伤后精神障碍的疗效。方法50例老年创伤精神障碍患者,年龄70～90岁。随机均分为丙泊酚组(A组)和咪唑安定组(B组),分别应用微量泵持续输注丙泊酚0.5mg·kg-1·h-1和咪唑安定0.04mg·kg-1·h-1治疗12h,比较两组Ramsay评分和治疗有效率,同时记录药物起效时间和停药后清醒时间,并监测用药前后的ECG、MAP、HR、SpO2和RR。结果A组达到Ramsay评分Ⅴ级(23例)明显多于B组(9例)(P<0.01)。精神症状改善者,A组为24例(有效率为96%),B组为18例(有效率为72%),治疗效果A组明显好于B组(P<0.01)。起效时间和清醒时间,两组相比差异有统计学意义(P<0.01)。两组用药后MAP、HR和RR比用药前明显下降(P<0.05),组间比较差异无统计学意义。结论丙泊酚可能是减轻ICU老年创伤精神障碍的一种有效方法。

Objective To study the effect of propofol on elderly post traumatic patients with mental confusion in ICU. Methods Fifty patients aged 70 to 90 years old with traumatic mental confusion after trauma were divided into groups propofol（group A） and midazolam （group B）, with 25 cases each. The patients were treated with propofol 0.5 mg·kg^-1·h^-1 in group A and midazolam 0. 04 mg·kg^-1·h^-1 in group B for 12 hrs respectively. Ramsay scale and therapeutic efficiency were compared between two groups. The time going to sleep and recovering from sleep were recorded. ECG,MAP,HR, SpO2 and respiratory rate were monitored before and after sedation. Results The sedative level： twenty-three patients in group A reached V degree, which was nine patients in group B. The average time going to sleep and recovering from sleep in group A were less than those in group B（P〈0.01）. The values of HR,MAP and respiratory rate after sedation were less than those before （P〈0.05）. Conclusion Propofol is effective and with less complication in the treatment of post traumatic patients with mental confusion in ICU.