右美托咪定与咪达唑仑用于ICU机械通气患者的镇静效果比较

Comparison of Sedative Effect of Dexmedetomidine and Midazolam on Patients with Comprehensive ICU Mechanical Ventilation

目的：比较右美托咪定与咪达唑仑用于重症医学科（ICU）机械通气患者的镇静效果。方法：74例ICU收治的患者，按随机数字表法分为右美托咪定组（37例）与咪达唑仑组（37例）。在机械通气治疗的基础上，右美托咪定组患者给予右美托咪定注射液200μg，溶于0.9％氯化钠注射液48ml中，先给予负荷剂量1μg/kg于30min内泵入完毕，再调整以0.2～0.7μg/（kg·h）微量泵入；咪达唑仑组患者给予咪达唑仑注射液30mg，溶于0.9％氯化钠注射液44ml中，先给予负荷剂量0.05mg/kg于15min内泵入完毕，再调整以0.04～0.20mg/（kg·h）微量泵入。观察两组患者镇静效果、临床指标（停药后撤机时间、停药后拔管时间、机械通气时间、ICU住院时间）及不良反应发生情况。结果：两组患者镇静效果差异无统计学意义（P＞0.05）；右美托咪定组患者停药后撤机时间、停药后拔管时间、ICU住院时间显著短于咪达唑仑组，差异均有统计学意义（P＜0.05）；右美托咪定组患者总不良反应发生率显著低于咪达唑仑组，差异有统计学意义（P＜0.05）。结论：右美托咪定用于ICU机械通气患者镇静效果与咪达唑仑相当，停药后撤机、拔管和ICU住院时间均短于咪达唑仑，且总不良反应发生率低于咪达唑仑。

OBJECTIVE:To compare the sedative effects of dexmedetomidine and midazolam in patients with comprehensiveICU mechanical ventilation. METHODS:74 patients in ICU were randomly divided into dexmedetomidine group(37 cases)andmidazolam group(37 cases). Based on mechanical ventilation,dexmedetomidine group received 200 μg Dexmedetomidine injection,dissolving in 48 ml 0.9% Sodium chloride injection,pumped by 1 μg/kg within 30 min,then adjusted to 0.2-0.7 μg/(kg·h)by micropump. Midazolam group received 30 mg Midazolam injection,dissolving in 44 ml 0.9% Sodium chloride injection,pumped by 0.05 mg/kg within 15 min,then adjusted to 0.04-0.20 mg/(kg·h)by micropump. The sedative effects,clinical indicators(weaning time,extubation time,time of mechanical ventilation,ICU hospitalization time)and the incidence of adverse reactionsin 2 groups were observed. RESULTS:There was no significant difference in the sedative effects(P>0.05);weaning time,extubation time,and ICU hospitalization time in dexmedetomidine group were significantly shorter than midazolam group,the differenceswere statistically significant(P<0.05);the incidence of total adverse reactions in dexmedetomidine group was significantlylower than midazolam group,the difference was statistically significant(P<0.05). CONCLUSIONS:Dexmedetomidine showsimilar sedative effects with midazolam in patients with comprehensive ICU mechanical ventilation,shorter weaning time,extubationtime,ICU hospitalization time,and lower incidence of total adverse reactions than midazolam.