右美托咪定注射液对重症患者谵妄的应用评价

Therapeutic effect of dexmedetomidine injection on patients with severe delirium

目的评价右美托咪定注射液在重症患者谵妄治疗中的价值。方法选取2013年2月至2015年2月我院重症监护病房(ICU)发生谵妄患者26例,随机分成2组:治疗组14例,对照组12例。观察应用右美托咪定后不同时间点ICDSC评分、Ramsay镇静评分、心率、平均动脉压、动脉血氧分压、动脉血二氧化碳分压的变化情况。结果谵妄患者经右美托咪定治疗后,Ramsay镇静评分高于对照组,ICDSC评分低于对照组,心率慢于对照组,动脉血二氧化碳分压低于对照组,动脉血氧分压高于对照组,两组上述指标比较差异有统计学意义(P<0.05),而平均动脉压比较差异无统计学意义(P>0.05)。结论右美托咪定具有中枢性抗交感、抗焦虑作用和较好的镇静作用,对呼吸无明显抑制,对谵妄有较好的治疗作用。

Objective To evaluate the effect of dexmedetomidine injection on severe delirium. Methods Twenty six patients with deliriumfromFebruary 2013 to February 2015 in ICU of our hospital were randomly divided into treatment group（ n = 14） and control group（ n = 12）. The ICDSC score,Ramsay sedation score,heart rate,mean arterial pressure（ MAP）,arterial oxygen branch pressure（ PaO_2）,arterial partial pressure of carbon dioxide（ PaCO_2）of the patients were recorded at different time points after treatment. Results After treatment,there were significant differences in the ICDSC score,Ramsay sedation score,heart rate,PaO_2 and PaCO_2 between the two groups（ P〈0. 05）,but no significant difference in MAP was found（ P〉0. 05）. Conclusion Dexmedetomidine has central sympatholytic and anxiolytic effects,approximate natural sleep sedative effect in the treatment of deliriumwithout respiratory depression.