舒芬太尼与地佐辛分别联合右美托咪定在重症心衰合并机械通气患者镇痛镇静中应用比较

Comparison of sufentanil and dezocine in combination with dexmedetomidine in analgesic sedation of patients with severe heart failure and mechanical ventilation

目的探讨舒芬太尼与地佐辛分别联合右美托咪定在重症心力衰竭(心衰)合并机械通气患者镇痛镇静中的应用效果。方法 70例重症心衰合并机械通气患者作为研究对象,随机分为对照组与观察组,每组35例。对照组采用舒芬太尼联合右美托咪定镇痛镇静,观察组采用地佐辛联合右美托咪定镇痛镇静。比较两组患者拔管时间、撤机时间、镇痛镇静效果及不良反应发生情况。结果观察组患者拔管时间(102.15±8.57)min、撤机时间(55.73±5.51)min均短于对照组的(118.94±12.32)、(61.05±7.32)min,差异均具有统计学意义(P<0.05)。观察组患者焦虑自评量表(SAS)评分(3.65±0.18)分、疼痛数字评分法(NRS)评分(1.48±0.98)分均低于对照组的(4.04±0.25)、(2.84±1.23)分,差异均具有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论对重症心衰合并机械通气患者采用地佐辛联合右美托咪定镇痛镇静具有明显的效果,且利于缩短拔管时间,值得推广应用。

Objective To investigate the application effect of sufentanil and dezocine in combinationwith dexmedetomidine in analgesic sedation of patients with severe heart failure and mechanical ventilation.Methods A total of70patients with severe heart failure and mechanical ventilation as study subjects wererandomly divided into control group and observation group,with35cases in each group.The control group wastreated with sufentanil and dexmedetomidine for analgesic sedation,and the observation group was treated withdezocine and dexmedetomidine for analgesic sedation.Comparison were made on extubation time,weaning time,analgesic sedation effect and occurrence of adverse reactions in two groups.Results The observation group hadshorter extubation time as(102.15±8.57)min,weaning time as(55.73±5.51)min than(118.94±12.32)and(61.05±7.32)min in the control group,and their difference was statistically significant(P<0.05).The observationgroup had self-rating anxiety scale(SAS)score as(3.65±0.18)points and numerical rating scale(NRS)score as(1.48±0.98)points,which were all lower than(4.04±0.25)and(2.84±1.23)points in the control group,and theirdifference was statistically significant(P<0.05).Both groups had no statistically significant difference in incidenceof adverse reactions(P>0.05).Conclusion Combination of dezocine and dexmedetomidine provides obviouseffect for patients with severe heart failure and mechanical ventilation,and it can shorten the time of extubation.Itis worthy of popularization and application.