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无负荷剂量右美托咪定镇静对老年危重病人血流动力学的影响 被引量:8

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摘要 目的探讨危重病人无负荷剂量应用右美托咪定镇静效果及对血流动力学的影响。方法随机选取2013年1~6月该院ICU收治的86例需要持续镇静的危重患者,APACHEⅡ评分(19±7)分,视患者临床情况给予舒芬太尼静脉持续泵入,使Prince-Henry疼痛评分≤3分。镇静方法采用无负荷剂量持续静脉输入右美托咪定,起始剂量0.4μg·kg-1·h-1,调整泵入剂量0.2~0.7μg·kg-1·h-1,使RSS评分3~4分。结果 74例(86.1%)患者能获得良好的镇静效果。在静脉泵入右美托咪定的第1个小时内,有12%的病人平均收缩压(SBP)下降,14%的病人心率下降。突然停药后,24 h持续观察SBP升高5%,心率升高18%。结论对于危重病人来说,不用负荷剂量持续泵入右美托咪定可以维持良好的镇静效果,维持泵入期间患者的血压、心率下降是可以预测并能有效控制的,持续应用超过24 h后突然停药未见明显的血流动力学反跳。
作者 陈阳 刘忠民
出处 《中国老年学杂志》 CAS CSCD 北大核心 2014年第24期6968-6970,共3页 Chinese Journal of Gerontology
基金 吉林省发改委科研项目(2013C027-2)
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