右美托咪定联合舒芬太尼对多发伤患者的镇静效果研究

Sedative Effect of Dexmedetomidine Combined with Sufentanil in Patients with Multiple Injuries

目的:研究右美托咪定联合舒芬太尼对多发伤患者的镇静效果。方法:选取2015年4月-2018年4月本院ICU收治的多发伤患者100例作为研究对象,按照随机数字表法将其分为试验组和对照组,各50例。对照组采用舒芬太尼持续微量泵镇静镇痛,试验组采用右美托咪定联合舒芬太尼持续微量泵静脉输注,观察比较两组用药后的Ramsay镇静评分、达标时间和疼痛视觉模拟(VAS)评分、用药前后的血流动力学及呼吸功能指标水平及不良反应发生情况。结果:用药后2、6、12、24、48 h,试验组的Ramsay镇静评分均明显优于对照组,且达标时间为(35.25±0.25)h明显短于对照组的(39.60±0.60)h,差异均有统计学意义(P<0.05)。两组用药前及用药后6、12、24、48 h的平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、心率(HR)水平比较,差异均无统计学意义(P>0.05)。对照组恶心呕吐、嗜睡、呼吸抑制发生率明显高于试验组,差异有统计学意义(x^2=13.652 4,P<0.05)。用药后2、6、12、24 h,试验组的VAS评分均明显低于对照组,差异均有统计学意义(P<0.05)。结论:右美托咪定联合舒芬太尼对多发伤患者具有很好的镇静效果,且不良反应发生率低,值得在临床推广应用。

Objective:To investigate the sedative effect of Dexmedetomidine combined with Sufentanil in patients with multiple injuries.Method:A total of 100 patients with multiple injuries admitted in the ICU of our hospital from April 2015 to April 2018 were selected as the research objects.According to the random number method,they were divided into experimental group and control group,50 cases in each group.The control group was sedated and analgesic with Sufentanil continuous micro-pump,the experimental group was given Dexmedetomidine combined with Sufentanil continuous micro-pump intravenous infusion.The Ramsay sedation score,time to reach the target and pain visual analogue(VAS)score,hemodynamics and respiratory function indexes before and after treatment and adverse reactions between the two groups were observed and compared.Result:After administration 2,6,12,24,48 h,the Ramsay sedation scores of the experimental group were significantly better than those of the control group,the time to reach the target was(35.25±0.25)h,which was significantly shorter than(39.60±0.60)h of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the levels of MAP,SpO2 and HR before and after administration 6,12,24 and 48 h between the two groups(P>0.05).The incidence of nausea,vomiting,sleepiness and respiratory depression in the control group was significantly higher than that in the experimental group,the difference was statistically significant(χ^2=13.652 4,P<0.05).After administration 2,6,12 and 24 h,the VAS scores of the experimental group were significantly lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Dexmedetomidine combined with Sufentanil has a good sedative effect on patients with multiple injuries and the incidence of adverse symptoms is low,which is worthy of clinical application.