三种镇静方案在ICU计划镇静的临床观察

Clinical observation of three kinds of sedation program implementation plan for sedation in the ICU

目的评价3种镇静方案在ICU计划镇静的效果。方法选择在ICU行机械通气需要计划镇静的患者60例,随机分为3组,平均每组20例,分为A组芬太尼0.5mg+咪达唑仑50mg+0.9%氯化钠溶液配成50mL,2mL/h、B组舒芬太尼50μg+咪达唑仑50mg+0.9%氯化钠溶液配成50mL,2mL/h及C组舒芬太尼100μg+咪达唑仑30mg+0.9%氯化钠溶液配成50mL,2mL/h。3组均进行每日唤醒和脱机训练。结果 3组在维持镇静量下血流动力学平稳。B组及C组在达到镇静目标的时间短于A组(P<0.05),但是停药后恢复苏醒的时间大于A组,但3组在ICU住院时间上差异无统计学意义。A、B组和C组分别有92%、95%、97%的患者产生遗忘。镇静费用比较:A组最低,C组明显高于A组及B组(P<0.05)。结论 ICU机械通气计划镇静患者B组对血流动力学影响不大,镇静效果满意,费用适中,减少药物不良反应,且镇静遗忘效果肯定,有利于保障患者的安全舒适性,具有安全性、有效性、经济性,值得推广。

Objective To evaluate the three kinds of sedation in the ICU program plan sedative effect.Methods Chose 60 patients of mechanical ventilation in ICU patients need sedation planned were randomly divided into 3 groups,each an average of 20 cases,divided into group A fentanyl 0.5 mg ＋ 50 mg ＋ midazolam saline dubbed 50 mL,2 mL/h,group B sufentanil 50 μg ＋ midazolam 50 mg＋saline dubbed 50 mL,2 mL/h and group C sufentanil 100 μg ＋ midazolam 30 mg ＋ saline dubbed 50 mL,2 mL/h.3 groups were carried out daily wake-up and offline training.The results of three groups to maintain stable hemodynamics under sedation amount.Group B and C targets in a short time to achieve sedation in group A（P 0.05）,but regained consciousness after treatment recovery time is greater than the group A,but three groups in the ICU length of stay was no significant difference.Group A and B and the group C were respectively 92% and 95%,97% of the patients had forgotten.Calm cost comparison：group A minimum,group C was significantly higher than the group A and B（P 0.05）.Conclusion ICU sedation in patients with mechanical ventilation plan group B has little effect on hemodynamics,sedation satisfaction,moderate cost,reduce adverse drug reactions,and the sedative effects are forgotten,comfortable and conducive to patient safety and reduce the patient＇s hospitalization,their safety,effectiveness,economy is the treatment of ICU sedation plan better choice.