小剂量右美托咪定对重症患者谵妄和应激反应的影响研究

Study on the effect of low-dose dexmedetomidine on delirium and stress response in critically ill patients

目的探究小剂量右美托咪定对重症患者谵妄与应激反应的影响。方法选取2019年5月至2021年5月本院收治的60例重症患者作为研究对象,采用随机分组法分为对照组和观察组,每组30例。两组均给予瑞芬太尼镇痛,对照组给予咪达唑仑镇静,观察组给予小剂量右美托咪定镇静,比较两组镇静效果、谵妄发生率、不良反应发生情况、应激反应水平[C反应蛋白(CRP)、血管紧张素Ⅱ(AngⅡ)、肾上腺素]。结果观察组治疗总有效率为86.67%,高于对照组的60.00%,差异有统计学意义(P<0.05)。观察组谵妄发生率为13.33%,不良反应发生率为6.67%,均低于对照组的40.00%、30.00%,差异有统计学意义(P<0.05)。治疗前,两组CRP、AngⅡ、肾上腺素水平比较差异无统计学意义;治疗后,两组CRP、AngⅡ、肾上腺素水均高于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论小剂量右美托咪定治疗重症患者效果确切,可有效降低谵妄发生率,改善应激反应水平,增强镇静效果,值得临床推广应用。

Objective To investigate the effect of low-dose dexmedetomidine on delirium and stress response in critically ill patients.Methods A total of 60 critically ill patients admitted to our hospital from May 2019 to May 2021 were selected as the research subjects,and they were divided into control group and observation group,with 30 cases in each group.Both groups were given refentanil analgesia,the control group was given midazolam analgesia,and the observation group was given low-dose dexmedetomidine analgesia,and the analgesia effect,delirium incidence,adverse reactions,and stress response levels(C-reactive protein[CRP],angiotensinⅡ[AngⅡ],epinephrine)were compared between the two groups.Results The total effective rate in the observation group was 86.67%,which was higher than 60.00%of the control group,and the difference was statistically significant(P<0.05).The incidence of delirium in the observation group was 13.33%and the incidence of adverse reactions was 6.67%,which were lower than 40.00%,30.00%of the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in CPR,AngⅡand epinephrine levels between the two groups;after treatment,CPR,AngⅡand epinephrine levels in the two groups were higher than before treatment,and the observation group was lower than in the control group,and the differences were statistically significant(P<0.05).Conclusion Low-dose dexmedetomidine can effectively reduce the incidence of delirium,improve the level of stress response,and improve clinical efficacy,which is worthy of clinical promotion and application.