重症加强护理病房机械通气患者中布托啡诺与地佐辛不良反应的对比研究

Comparative Study on Adverse Reactions of Butorphanol and Dezocine in Patients with Mechanically Ventilated in Intensive Care Unit

目的:比较重症加强护理病房(ICU)机械通气患者使用布托啡诺或地佐辛持续镇痛治疗时不良反应的发生情况。方法:对2018年6月~2020年6月期间入住本院ICU并连续输注布托啡诺或地佐辛24h以上的患者(年龄≥18岁)进行回顾性研究。收集两组患者基线特征数据,记录两组患者用药后72h内发生的不良反应。结果:共纳入173例患者,布托啡诺组77例,地佐辛组96例。两组患者急性胃肠损伤(AGI)、低心率、低血压和谵妄的发生率比较无统计学差异。其中,AGI发生率最高(21.4%)。AGI的发生与患者急性生理与慢性健康评分(APACHEⅡ)以及既往消化道疾病史有显著相关性(P<0.05)。结论:布托啡诺或地佐辛用于ICU机械通气患者的不良反应以AGI为主,AGI的发生受APACHEⅡ和既往消化道疾病史的影响。

Objective:To compare the adverse reactions of butorphanol and dezocine for continuous analgesia in patients with mechanically ventilated in intensive care unit(ICU).Methods:A retrospective study was conducted on patients(aged≥18 years)admitted from June 2018 to June 2020 in the ICU of our hospital who received continuous butorphanol or dezocine for more than 24 h.Baseline characteristic data of patients in both groups were collected,and adverse reactions occurred within 72 h after treatment were recorded.Results:A total of 173 patients were enrolled,77 in the butorphanol group and 96 in the dezocine group.There was no significant difference in the incidence of acute gastrointestinal injury(AGI),low heart rate,hypotension and delirium between the two groups.Among them,the incidence of AGI was the highest(21.4%).The occurrence of AGI was significantly correlated with acute physiology and chronic health evaluationⅡ(APACHEⅡ)and previous history of gastrointestinal diseases(P<0.05).Conclusion:The adverse reactions of butorphanol or dezocine in patients with mechanical ventilation in ICU are mainly AGI,and the occurrence of AGI is affected by APACHEⅡand previous history of gastrointestinal diseases.