右美托咪定与地西泮对酒精戒断综合征患者镇静效果及安全性影响的对比分析

目的比较右美托咪定与地西泮对酒精戒断综合征（AWS）患者镇静效果及安全性的影响。方法选择2015年11月至2016年11月酒精戒断综合征患者60例，随机分为观察组和对照组，各30例。两组患者入院后完善血常规、心电图、彩超等实验室及影像学检查，同时均给予补液、营养支持、止痛等一般常规对症治疗；在此基础上，对照组给予地西泮镇静治疗，观察组给予右美托咪定镇静治疗。疗程结束后，比较两组患者镇静有效率、用药过程中基础生命体征变化情况、APACHEⅡ评分及不良反应发生情况。结果经过不同方式治疗后，观察组患者的镇静有效率明显高于对照组，差异有统计学意义（x2=5．45，P=0．02）；观察组患者于用药后1h即出现心率、血压明显下降，血氧饱和度明显上升，而对照组患者心率于用药后2h才出现心率明显下降，3h出现血氧饱和度明显上升，差异均有统计学意义（P〈0．05）；观察组患者心率、血氧饱和度早用药后各时间点均较对照组明显改善，比较差异有统计学意义（P〈0．05）；观察组患者血压于用药后1h下降程度明显高于对照组，差异有统计学意义（P〈0．05），两组患者APACHEII评分较治疗前均明显降低，且观察组患者降低幅度明显高于对照组，差异均有统计学意义（P〈0．05）；观察组患者不良反应发生率明显低于对照组，差异有统计学意义（P〈O．05）。结论右美托咪定对AWS患者的治疗具有起效快、有效率高、降心率、血压明显、呼吸抑制及谵妄发生率低、可长期应用的特点，同时不存在过度镇静的情况，值得在临床推广使用。

Objective To compare the effect of dexmedetomidine and diazepam on sedation and safety of alcohol withdrawal syndrome. Methods 60 patients with alcohol withdrawal syndrome were selected from November 2015 to November 2016 and divided into observation group and control group according to the random number method with 30 cases in each group. Two groups of patients improved the blood, electrocardiogram, color Doppler ultrasound and other laboratory and imaging studies after admission, while gived rehydration, nutritional support, analgesic general symptomatic treatment. On this basis, the control group was given diazepam sedation treatment, the observation group was given dexmedetomidine sedation treatment. After the end of treatment, the two groups of patients were compared with sedative efficiency, changes in basic vital signs during treatment, APACHE lI score and the incidence of adverse reactions. Results After treatment in different ways, the effective rate of sedation in the observation group was significantly higher than that in the control group （ X 2=5.45, P=0.02 ） . In the observation group, the heart rate, blood pressure and blood oxygen saturation were significantly increased at 1 hour after treatment, while the control group of patients with heart rate 2h after the emergence of heart rate decreased significantly, 3h appeared significandy increased oxygen saturation, the difference was statistically significant （ P〈0.05 ） . The heart rate and blood oxygen saturation of the observation group were significanfly improved at all time points after treatment, compared with the control group （ P〈0.05 ） . The blood pressure of the observation group was significantly higher than that of the control group at 1 hour after treatment, the difference was statistically significant （ P〈0.05 ） . APACHE II score in both groups was significantly lower than that before treatment, and the rate of reduction in the observation group was significantly higher than that in the control group （ P〈0.05 ） . The incidence of adverse reactions was significantly lower in the observation group than in the control group, and the incidence of respiratory depression was significandy lower in the observation group than in the control group, and the difference was statistically significant （ P〈0.05 ） . Conclusion Dexmedetomidine treatment of AWS patients have rapid onset, high efficiency, lower heart rate blood pressure, respiratory depression and the incidence of delirium is low, long-term application of the characteristics, at the same time there is no excessive cairn of the situation, it is worth to promote the use of clinical.