右美托咪定用于脑出血患者的镇静效果

Sedative effect of dexmedetomidine on patients with cerebral hemorrhage

目的观察脑出血患者应用右美托咪定的镇静效果。方法 100例脑出血患者随机分为观察组和对照组,每组50例,分别给予右美托咪定和咪达唑仑镇静治疗,监测患者心率、血压、呼吸频率变化及不良反应发生率,并记录用药后2组患者格拉斯哥(GCS)评分、急性生理学与慢性健康状况评分系统(APECHIⅡ)评分变化。结果与对照组比较,观察组患者在用药期间心率和血压变化差异无统计学意义(P>0.05),但观察组患者呼吸抑制率较低,与对照组比较差异有统计学意义(P<0.05);观察组患者镇静后再出血、脑梗死及脑疝形成发生率较对照组均显著降低(P<0.05);用药后48 h与对照组比较,观察组患者的GCS评分明显增高,APECHIⅡ评分显著降低,差异均有统计学意义(P<0.05)。结论右美托咪定用于脑出血患者能够更好地达到满意的镇静深度,患者用药期间呼吸更稳定,不良反应发生率低,是一种较为理想的镇静剂。

Objective To observe the sedative effect of dexmedetomidine on patients with cerebral hemorrhage. Methods A total of 100 patients with cerebral hemorrhage were randomly divided into observation group and control group,with 50 patients in each group. The patients in observation group and control group were given dexmedetomidine and midazolam for sedation therapy respectively. Heart rate,blood pressure,respiratory frequency and the incidence of adverse reactions were continually monitored. Changes of Glasgow coma scale（ GCS） score and acute physiology and chronic health evaluation scoring system（ APECHI Ⅱ） score were recorded before the drug withdrawal. Results The differences in heart rate and blood pressure between the two groups were not significant（ P 0. 05）,but the observation group had significantly lower respiratory depression rate（ P 0. 05）. Compared with the control group,the observathion group had significantly lower incidence of bleeding,cerebral infarction and cerebral hernia（ P 0. 05）. Compared with control group,GCS scores in observation group were increased significantly at 48 h after treatment while APECHI Ⅱ scores in observation group were decreased significantly（ P 0. 05）. Conclusion Dexmedetomidine is an ideal sedative drug used in patients with cerebral hemorrhage. It can achieve satisfactory sedative effect in patients with cerebral hemorrhage,the respiration is more stable and incidence rate of adverse reactions is lower.