右美托咪啶在重症患者谵妄的预防和治疗作用研究进展

Dexmedetomidine in the prevention and treatment of delirium in critically ill patients

背景 重症患者谵妄的发生率较高，并且谵妄的发生会增加重症患者并发症的发生率及病死率。右美托咪啶（dexmedetomidine，DEX）是一种较新型的镇静药，具有镇静、镇痛作用。临床试验证实其在重症医学科谵妄预防和治疗中具有独特优势。目的 综述DEX在重症医学科谵妄预防和治疗中的作用。内容 阐述谵妄的流行病学及危险因素，DEX的药理特点，预防和治疗谵妄的机制及其在重症患者谵妄预防和治疗中的应用。趋向 DEX可以有效预防并控制重症患者谵妄的发生，其有效性和安全生尚需要进一步的临床研究证实。

Background The incidence of delirium in the critically ill patients is high, which could increase the incidence of complications and mortality rate. Dexmedetomidine is a relatively new agent used in intensive care unit （ICU）, with satisfactory sedative and analgesic properties. Clinical trials have proved its advantages on prevention and control of delirium in ICU. Objective Our current article reviewed the effect of dexmedetomidine on prevention and treatment of delirium in ICU. Content This article described the epidemiology and risk factors of delirium, pharmacological characteristics of dexmedetomidine,mechanism for its prevention and treatment of delirium, and application strategy of dexmedetomidine in prevention and control of delirium in ICU. Trend Dexmedetomidine can effectively prevent and control the occurrence of delirium in critically ill patients. However, further studies are warranted to evalauate its effectiveness and safety for delirium prevention or management in ICU.