序贯应用咪达唑仑和丙泊酚对有创通气病人镇静效果

THE EFFECT OF SEQUENTIAL APPLICATION OF MIDAZOLAM AND PROPOFOL ON SEDATION IN PATIENTS UNDERGOING INVASIVE VENTILATION

目的探讨序贯应用咪达唑仑、丙泊酚对有创通气病人的镇静效果。方法将119例有创通气的病人随机分为咪达唑仑组（A组）、丙泊酚组（B组）及咪达唑仑并丙泊酚组（C组）,对3组病人生命体征、Ramsay评分、不良反应、带管时间、重症监护病房（ICU）入住时间进行比较。结果镇静期间,3组心率、呼吸、平均动脉压、血氧饱和度、急性生理和慢性健康状况评估Ⅱ评分、Ramsay评分比较差异无显著性（P〉0.05）;C组与A组相比,谵妄的发生率明显降低（χ~2=6.124,P〈0.05）,与B组比较差异无显著性（P〉0.05）;C组与B组相比,低血压发生率明显降低（χ~2=4.391,P〈0.05）,与A组比较差异无显著性（P〉0.05）。结论有创通气病人序贯应用咪达唑仑、丙泊酚镇静效果可靠,不良反应少。

Objective To assess the sedative effect of sequential application of midazolam and propofol on patients with invasive ventilation（IV）. Methods This study was carried out in 119 patients undergoing IV,who were randomized to midazolam group（group A）,propofol group（group B）,and midazolam ＋ propofol group（group C）.The vital signs,Ramsay score,adverse reactions,time of indwelling tube,and duration of ICU staying were compared among the three groups. Results During sedation,the differences in the heart rate,respiration,mean arterial pressure,oxygen saturation,physiological and chronic health evaluation Ⅱ as well as Ramsay score among the three groups were not significant（P〉0.05）.Compared with group A,the incidence of postoperative delirium in group C obviously decreased（χ~2=6.124,P〈0.05）,and that in group B was not significant（P〉0.05）.Compared with group B,the incidence of hypotension in group C was significantly lower（χ~2=4.391,P〈0.05）,and the difference in that between groups A and C was not significant（P〉0.05）.Conclusion The efficacy of sequential application of mi-dazolam and propofol for sedation in patients undergoing invasive ventilation is reliable and with less adverse reactions.