咪唑安定对机械通气患者长程镇静的疗效观察

The Effect of Midazolam for Long-Term Sedation in Mechanic Ventilation Patients

目的 :观察咪唑安定在机械通气患者中的应用 ,评价其长程镇静效果。方法 :2 0例符合纳入和排除标准的长程机械通气患者 ,给予咪唑安定静脉注射泵持续泵入 ,负荷剂量 0 1～ 0 15mg/kg ,维持量 0 0 5～0 15mg/kg/h ,观察镇静评分 (Ramsayscore,RS)、血压、脉搏、脉搏血氧饱和度 (SpO2 )及呼吸频率的变化。结果 :所有对象在给予咪唑安定负荷剂量后 ,RS从 1级下降至 3～ 5级 ,达到很好的镇静要求 ,且在维持量下能保持镇静水平的稳定 ,总有效率 10 0 % ,患者循环系统各指标在用药前后和维持过程中均无明显差异 (P >0 0 1) ,自主呼吸频率用药后 (平均 18 0± 6 7次 /分 )与用药前 (平均 2 5 4± 10 7次 /分 )相比有明显改善 (P <0 0 1)。结论 :咪唑安定静脉持续注射对机械通气患者有很好的长程镇静效果 ,循环影响小 ,能很好地保持患者的自主呼吸与机械通气协调 ,减少人机对抗。

Objective:Evaluation the effect of midazolam for long-term sedation in ventilation patients.Methods:20 cases who receive long-term mechanic ventilation were admitted and treated by continuous infusing midazolam(first 0 1～0 15mg/kg,then 0 05～0 15mg/kg/h).Observe the change of Ramsay score,Blood pressure,pulse,SpO 2 and breath.Results:All cases get a excellent sedation level after midazolam administer(RS from 1 to 3～5),circulation had no adverse reaction during midazolam infusion( P >0 01).But spontaneous breath rate decrease to 18 0±6 7/min compare with 25 4±10 7/min before.statistically significant difference( P <0 01).Conclusion:continuous midazolam infusion have an excellent effect for long-term sedation in ventilation patients.Few influence on circulation.Also can maintain the coordination between spontaneous breath and mechanic ventilation.