右美托咪定与咪唑安定联合瑞芬太尼对创伤患者机械通气时的镇静镇痛疗效比较

Comparison of Sedation and Analgesia Effect of Dexmedetomidine and Midazolam Combined with Remifentanil in Treating Trauma Patients during Mechanical Ventilation

目的比较右美托咪啶与咪唑安定联合瑞芬太尼对创伤患者机械通气时镇静镇痛的临床效果。方法将100例患者按随机数字表法分为A组和B组。A组患者采用右美托咪啶治疗,B组患者采用咪唑安定联合瑞芬太尼治疗。结果两组患者舒张压、心率比较,差异无统计学意义(P>0.05);A组收缩压显著低于B组,每搏输出量显著高于B组(P<0.05);两组患者呼气末二氧化碳压力(P_(ET)CO_2)比较,无统计学差异(P>0.05);A组系统血管阻力指数(SVRI)显著低于B组(P<0.05);A组镇静起效、停药后撤机、停药后拔管、唤醒及机械通气时间均显著短于B组(P<0.05);A组疼痛总有效率显著高于B组(P<0.05)。结论右美托咪啶应用于创伤患者机械通气镇静镇痛效果优于咪唑安定联合瑞芬太尼,值得推广。

Objective To compare the sedation and analgesia effect of dexmedetomidine and midazolam combined with remifentanil in treating trauma patients during mechanical ventilation.Methods 100 patients were randomly divided into group A,group B according to the random number table method.Group A received dexmedetomidine treatment,group B received midazolam + remifentanil treatment.Results The blood pressure,heart rate of the two groups had no statistically significant difference( P > 0.05); the systolic blood pressure of the group A was significantly lower than group B,and the stroke volume was significantly higher than group B( P <0.05); P_(ET)CO_2 were not statistically different between the two groups( P > 0.05); SVRI of the group A was significantly lower than the group B( P < 0.05); the sedation onset time,stopping retreat machine time,extubation time after stopping,the time and duration of mechanical ventilation of the group A were significantly shorter than the group B( P < 0.05); the pain effective rate of the group A was significantly higher than group B( P < 0.05).Conclusion The efficacy of dexmedetomidine in treating trauma patients during mechanically ventilation is better than midazolam combined with remifentanil,which is worthy of promotion.