右美托咪定和咪达唑仑对脑外伤患者术后谵妄的临床影响比较

Comparative Analysis of the Influence of Postoperative Delirium Mediated by Dexmedetomidine and Midazolam in Serious Traumatic Brain Injury Patients

目的:观察右美托咪定和咪达唑仑对ICU内重症颅脑外伤患者术后谵妄的影响比较。方法:选取术后重症颅脑外伤患者100例,随机分别给予右美托咪定(观察组,50例)和咪达唑仑(对照组,50例)持续静脉泵入镇静。每日采用ICU意识紊乱评估法(CAM-ICU)来评估谵妄发生率。结果:与咪达唑仑组相比,右美托咪定组患者谵妄发生率明显低(P<0.05);两组患者恶心、呕吐、嗜睡、低血压、心动过缓等术后不良反应比较差异均无统计学意义(P>0.05)。结论:右美托咪定可明显降低脑外伤患者术后谵妄的发生率,可作为ICU的一种有效的术后镇静药。

Objective：To compare the clinical effect of Dexmedetomidine and Midazolam in the influence of postoperative delirium in patients with serious traumatic brain injury.Method：100 patients who were treated with serious cerebral trauma were divided into the Dexmedetomidine group（the observation group,n=50） and the Midazolam group（the control group,n=50） according to the random number table method.Dexmedetomidine was implemented to patients in the observation group and Midazolam was carried out on patients in the control group.Consciousness evaluation method of the ICU was utilized for the comparison of the incidence of delirium.Result：Compared with the Midazolam group,the incidence of delirium of the Dexmedetomidine group was significantly reduced（P〈0.05）.No significant difference was examined in the aspects of the nausea,vomiting,lethargy,hypotension,bradycardia and other complications after the surgery of the two groups（P〉0.05）.Conclusion：Dexmedetomidine can reduce the incidence of postoperative delirium in patients who have been operated with the surgery of cerebral trauma.It can be used as an effective postoperative ICU sedatives.