右美托咪啶与咪达唑仑对重症监护患者镇静作用的对比研究

目的比较右美托咪(Dex)和咪达唑仑(MDZ)对重症监护室(ICU)患者的镇静作用。方法收集247例在ICU治疗的患者,随机纳入D组和M组分别泵入Dex和MDZ,采用镇静-躁动评分(RASS)维持RASS评分(-2～+1)。记录各组出现躁动患者的百分比,目标镇静的维持时间,机械通气持续时间,ICU治疗总时间和不良反应。结果D组躁动百分比为46.3%,M组为77.9%,两组比较差异有显著性(P<0.05);两组目标镇静维持时间和ICU治疗总时间差异无显著性;机械通气时间D组小于M组(P<0.05)。D组易出现心动过缓,但其它不良反应较M组减少。结论Dex和MD对ICU患者目标镇静维持时间和ICU治疗时间无显著差异。但Dex显著缩短了患者机械通气时间,并在治疗中较少出现不良反应。

A comparative study on sedative effect of dexmedetomidine and midazolam in ICU patients

Objective To compare the sedative efficacy of dexmedetomidine （Dex） with midazolam（MDZ） in intensive care unit （ICU） patients. Methods This study conducted in 247 patients in ICU of this hospital during March 2008 to November 2011. These patients were randomly assigned to Dex or MDZ group and infused with Dex or MDZ respectively. The levels of sedation and delirium were assessed by using the Richmond Agitation Sedation Scale （RASS） and the scores were maintained between ？ 2 and ＋ 1. The percentage of patients had delirium during the treatment course, the duration within target RASS range, the duration of mechanical ventilation, length of ICU staying and adverse events during treatment were recorded. Results The percentage of delirium was 46.3% in Dex - treated patients vs 77.9% in MDZ - treated patients（ P 〈0.05 ）. There was no difference in time within the target RASS range and ICU length. Patients with mechanical ventilation was shorter in Dex group than that of MDZ group（ P 〈0.05 ）. Dex treated patients were more likely to develop bradycardia, but it had lower incidence of adverse events. Conclusion There is no difference between Dex and MDZ in duration of targeted sedation and length of ICU in patients. But patients in Dex group spend less time on the ventilator, and experienced less adverse events.