咪达唑仑联合芬太尼对ICU中慢性阻塞性肺疾病机械通气患者的镇静效果评价

Sedative effect evaluation of patients with COPD using mechanical ventilation treated by midazolam and fentanyl in ICU

目的探讨ICU中慢性阻塞性肺疾病机械通气患者采用咪达唑仑与芬太尼联合镇静的效果。方法本次研究选择的对象共100例,均为本院ICU2007年1月～2013年1月收治的COPD采用机械通气治疗的患者,采用咪达唑仑与芬太尼联合镇静,回顾临床资料。结果与治疗前比较,治疗后Ramsay镇静评分、SpO2水平、PCO2水平、PO2水平、pH水平均有改善,差异有统计学意义(P<0.05)。呼吸动力学各指标与治疗前比较均有明显改善,差异有统计学意义(P<0.05)。均未出现严重不良反应。结论 ICU中慢性阻塞性肺疾病行机械通气治疗的患者采用咪达唑仑与芬太尼联合应用,可起到较佳的镇静效果,促使临床疗效增强,改善患者不适症状,具有较高安全性,值得在临床广泛推广应用。

Objective To explore the sedative effects of midazolam and fentanyl in the treatment of patients with chronic obstructive pulmonary disease （COPD） using mechanical ventilation in intensive care unit （ICU）. Methods Clinical data from 100 COPD patients using mechanical ventilation admitted into our ICU and treated by midazolam and fentanyl from January 2007 to January 2013 were selected and retrospectively analyzed. Results Compared with pretreatment, the Ramsay sedation score after treatment, and levels of Sp02, PCO2, P02, and pH levels were improved, which displayed statistical differences （P 〈 0.05）. The respiratory mechanics indicators showed significant improvement after treatment compared with before with statistical differences （P 〈 0.05）. After treatment, no severe adverse reactions occurred in all cases. Conclusion Joint application of midazolam and fentanyl in the treatment of COPD patients with mechanical ventilation can obtain an optimum sedative effect. It enhances the clinical efficacy, improves symptoms, and shows high safety, which is worthy of wide application and extension in clinic.