右美托咪定和咪达唑仑对重型颅脑外伤患者血流动力学的影响及镇静效果比较

Comparison of hemodynamics and sedative effect between dexmedetomidine and midazolam in patients with severe traumatic brain injury

目的明确右美托咪定及咪达唑仑对重型颅脑外伤患者血流动力学的影响及镇静效果。方法选取EICU收治的重型颅脑外伤患者98例，随机分为丽组，右美托咪定组（D组）49例及咪达唑仑组（M组）49例。D组患者采用静脉泵入右美托咪定镇静治疗，M组患者采用静脉泵入咪达唑仑镇静，记录两组患者用药前及用药后5、30、60、120min的心率、血压、血氧饱和度，并评估不同时间点的Ramsay镇静评分。结果D组患者在镇静前后各个时间点的心率、舒张压、脉氧维持稳定（P〉0．05），M组患者的血流动力学参数则波动明显（P〈0．05），且D组患者镇静后30、60min的Ramsay镇静评分均大于M组（P〈0．05）。结论右美托咪定对重型颅脑外伤患者血流动力学的影响较小，镇静效果优于咪达唑仑。

Objective To reveal hemodynamic and sedative effect between dexmedetomidine and midazolam in patients with severe traumatic brain injury. Methods A total of 98 patients of severe traumatic brain injury were randomly divided into two groups, 49 cases of dexmedetomidine group （D group） and 49 cases of midazolam group （group M）. Heart rate, blood pressure, blood oxygen saturation in two groups were recorded at the time points of before sedation, and 5 minutes, 30 minutes, 60 minutes, 120 minutes after sedation. Ramsay sedation score were evaluated at different time points. Results Heart rate, diastolic blood pressure, blood oxygen saturation in group D were maintain stable at every time points after sedation （P 〉0.05）. The hemodynamic parameters in patients of group M were obvious fluctuated （P 〈0.05）. Ramsay sedation score after 5 minutes,30 minutes; 60 minutes of sedation in patients of group D were higher than group M（P 〈0.05）. Conclusion Dexmedetomidine carries out a feature of an obvious sedation effect than Midazolam for patients who suffer from severe traumatic brain injury and a little effect on their hemodynamics.