右美托咪啶在脑外伤患者术后行CT检查过程中的应用

Dexmedetomidine Applied in Cerebral Trauma Patients during CT Detection after Surgery

目的观察右美托咪啶在脑外伤患者术后行CT检查过程中的应用效果。方法选取本院3个月内因脑外伤行急诊手术、术后需行CT检查的50例患者,随机分为右美托咪啶组(25例)和咪达唑仑组(25例)。右美托咪啶组应用电子输注泵10 min内给予负荷剂量右美托咪啶1μg/kg,继以0.2～0.7μg/(kg.h)的速度维持;咪达唑仑组10 min内予咪达唑仑负荷剂量0.06 mg/kg,再以0.04～0.20 mg/(kg.h)的速度维持。比较两组在CT检查过程中的镇静效果,记录患者的血氧饱和度、呼吸频率、血压、心率和呼气末二氧化碳分压(PetCO2),观察不良反应。结果右美托咪啶组镇静效果优良率为92.0%,咪达唑仑组为68.0%,两组比较差异有统计学意义(P<0.05);咪达唑仑组心率、血压、呼吸、血氧饱和度较右美括咪啶组波动大(P<0.05),在回到ICU时(T5)PetCO2高于右美托咪啶组和本组手术结束时(T0)(P<0.05);右美托咪啶组不良反应发生率为16.0%,咪达唑仑组为52.0%,两组比较差异有统计学意义(P<0.05)。结论右美托咪啶可作为脑外伤患者术后行CT检查过程中的首选镇静镇痛药物。

Objective To study the effect of Dexmedetomidine in traumatic brain injury patients during CT detection after surgery.Methods 50 patients who underwent emergency brain surgery after trauma and CT detection in our hospital within 3 months were randomly divided into the Dexmedetomidine group and Midazolam group（25 in each）.Loading dose of the Dexmedetomidine 1 μg/kg was infused for 10 min by electronic infusion pump in Dexmedetomidine group,then followed by 0.2-0.7μg/（kg·h） maintenance;within loading dose of Midazolam 0.06 mg/kg was prior to infusion for 10 min,then followed by 0.04-0.20 mg/（kg·h） to maintenance in Midazolam group.Appeasement effect in the two groups was compared,and oxygen saturation,respiratory rate,blood pressure,heart rate and end-tidal pressure of carbon dioxide were recorded,and the adverse reactions were observed.Results The good effect rates of appeasement in Dexmedetomidine group and Midazolam group were 92.0% and 68.0% respectively,and the differences were significant（P0.05）;Fluctuations of oxygen saturation,respiratory rate,blood pressure and heart rate in Midazolam group were higher than those in Dexmedetomidine group（P0.05）;End-tidal pressure of carbon dioxide in end-tidal pressure of carbon dioxide were higher（T5）than that after surgery（T0） when being returned to ICU;the adverse reaction rates in Dexmedetomidine group and Midazolam group were 16.0% and 52.0% respectively,and the differences were significant（P0.05）.Conclusion Dexmedetomidine can be applied as the first choice of sedative and analgesic drugs for cerebral trauma patients during CT detection after surgery.