不同剂量右美托咪定的镇静效果和对呼吸及循环功能的影响

Effects of different doses of dexmedetomidine on sedation and its influence on respiratory and circulatory function

目的:探讨和分析不同剂量右美托咪定的镇静效果和对呼吸及循环功能的影响。方法:选择进行机械通气的160例患者为研究对象,依入院顺序分甲组、乙组各80例。所有患者均通过静脉微泵泵入右美托咪定,乙组患者的负荷剂量为0.5μg/kg,维持剂量为0.2μg/(kg·h);甲组患者的负荷剂量为1.0μg/kg,维持剂量为0.4μg/(kg·h)。评价甲、乙两组患者不同时间的镇静效果、呼吸循环功能、吗啡总用量和从输注停止到拔管的时间。结果:甲组患者T_1-T_4的镇静评分与乙组患者T_1-T_3的镇静评分均低于T_0,甲组患者T_3-T_4的镇静评分均低于乙组(P<0.05),但甲、乙两组患者T_5-T_6的镇静评分比较差异无统计学意义(P>0.05);甲组患者T_1-T_4的心率和乙组患者T_1-T_5的心率低于T_0(P<0.05);甲组患者T_2-T_5收缩压和乙组患者T_1-T_5收缩压低于T_0(P<0.05),甲组患者T_2-T_6舒张压和乙组患者T_1-T_4舒张压低于T_0(P<0.05);两组患者血氧饱和度均无明显变化(P>0.05);两组患者的吗啡用量差异无统计学意义(P>0.05);甲组患者从输注停止到拔管的时间长于乙组患者(P<0.05)。结论:右美托咪定可降低患者的心率、血压,增加右美托咪定剂量时,患者的镇静效果并未增强,但恢复时间以及气管导管拔出时间均延长。

Objective ：To investigate and analyze the sedative effect of different doses of dexmedetomidine and its influence on respiratory and circulatory function. Methods ：160 patients with mechanical ventilation in our hospital were selected as the research objects and divided into group A and group B according to the order of admission, 80 cases in each group. All patients were pumped into dexmedetomidine by intravenous micropump. The load dose for group B was 0.5 μg/kg, and the maintenance dose was 0.2μg/（ kg · h）. The load dose for group A was 1.0μg/kg, and the maintenance dose was 0.4μg/（ kg · h）. The sedative effect, respiratory and circulatory function, the total dosage of morphine and tbe time of infusion stopped to extobation of the two groups at different times were evaluated. Results：The T1 -T4 sedation score in group A and T1 -T3 sedation score in group B were lower than To, and T3 -T4 sedation scores in group A were lower than those in group B （ P 〈 0.05 ）. However, there was no difference in T5 - T6 sedation scores between the two groups （ P 〉 0.05 ）. The T1 - T4 heart rates in group A and T1 - T5 heart rates in group B were lower than To（ P 〈 0.05）. The T2 - T5 systolic blood pressure in group A and T1 - T5 systolic blood pressure in group B were lower than To（ P 〈 0.05 ）. The T2 - T6 diastolic blood pressure in group A and T1 - T4 diastolic blood pressure in group B were lower than T0 （ P 〈 0.05）. There was no significant difference in blood oxygen saturation between the two groups （ P 〉 0.05）. There was no difference in the amount of morphine used between the two groups （ P 〉 0. 05 ）. The infusion stopped to extubatian time in group A was longer than that in group B （ P 〈 0.05 ）. Conclusion： Dexmedetomidine can reduce the heart rate and blood pressure of patients. When the dexmedetomidine dose is increased, the patient＇s sedative effect does not increase while the recovery time and the tracheal extuba- tion time are prolonged.