右美托咪定对气管插管重症颅脑损伤患者镇静效果评价

Evaluation of the effectiveness and safety of dexmedetomidine on tracheal intubation in patients with severe craniocerebral injury sedative effect

目的探讨右美托咪定对重症颅脑损伤患者气管插管镇静的临床效果及安全性。方法将116例气管插管的重症颅脑损伤患者采用随机数字表法随机分为两组,对照组(59例)给咪达唑仑镇静治疗,观察组(57例)给予右美托咪定镇静治疗。观察两组的达到目标镇静的时间、机械通气时间、停药至唤醒所需时间和不良反应的发生率。结果观察组达到目标镇静的时间、机械通气时间、停药至唤醒所需时间分别为(29.85±12.11)min、(135.15±23.67)h和(84.16±10.35)min,对照组为(35.15±10.29)min、(155.26±20.35)h和(105.16±25.17)min,两组比较具有统计学差异(t=6.319、5.869和6.124,均P<0.05);观察组低血压、呼吸抑制和谵妄发生率(12.28%、0和5.26%)与对照组(20.34%、15.25%和22.03%)比较具有统计学差异(χ~2=4.327、χ~2=7.415和χ~2=6.85,P<0.05);观察组心动过缓发生率(14.04%)比对照组(3.39%)高,但无统计学差异(χ~2=2.929,P>0.05)。结论右美托咪定应用于重症颅脑损伤患者的气管插管镇静之中可以获得满意的镇静效果,不良反应发生率更低,是一种安全有效的镇静药物。

Objective To investigate the clinical effect and safety of severe craniocerebral injury patients with tracheal intubation of dexmedetomidine sedation. Method 116 patients with severe craniocerebral injury were selected and randomly divided into observation group and control group. Control group( 59 cases) to midazolam sedation therapy,observation group( 57 cases) received dexmedetomidine sedation therapy. The target sedation time,mechanical ventilation time and the time to wake up and the incidence of adverse reactions were observed and compared between the two groups. Results The target sedation time,mechanical ventilation time and the time to wake up in the observation group were( 29.85 ±12.11) min,( 135.15±23.67) and( 84.16±10.35) min,in the control group were( 35.15±10.29) min,( 155.26±20.35) h and( 105.16± 25.17) min. There is a statistically significant difference between groups( t = 6.319,5.869 and 6.124,P< 0.05). The incidence of low blood pressure,respiratory depression and delirium were 12.28%,0,5.26% in the observation group and20.34%,15.25%,22.03% in the control group. The differences were statistically significant( χ2= 4.327,χ2=7.415 and χ2= 6.85,P < 0. 05). The incidence of of bradycardia were 14. 04% in the observation group,and3.39% in the control group. There was no statistical difference between two groups. Conclusion The application of dexmedetomidine in patients with severe craniocerebral injury of tracheal intubation can obtain satisfactory sedative sedative effect,the incidence rate of adverse reaction is lower,it is a safe and effective sedation scheme.