右美托咪定联合舒芬太尼在年轻患者术后谵妄中的应用

目的 观察右美托咪定联合舒芬太尼在年轻患者术后谵妄的中的效果。方法 选取笔者医院40例术后谵妄入ICU的年轻患者，随机分为4组，右美托咪定组（D组），舒芬太尼组（S组），右美托咪定联合舒芬太尼组（DS1组），小剂量联合组（DS2组），记录患者术后入ICU T₁（0h）、T₂（1h）、T₃（2h）、T₄（4h）、T₅（8h）各时间点生命体征、视觉模拟评分（VAS）、镇静-躁动评分（SAS）、CAM-ICU评分、舒芬太尼总用量及呼吸遗忘次数。结果 与D组相比较，其余3组在T₂、T₃、T₄、T₅时刻VAS，SAS和谵妄的发生率降低，差异有统计学意义（P<0.05）；在T₃、T₄、T₅其余3组心率，血压降低，差异有统计学意义（P<0.05）；与S组相比较，DS1组在T₃，T₄，T₅时刻VAS，SAS和谵妄的发生率显著降低，差异有统计学意义（P<0.05）。DS2组舒芬太尼使用量，呼吸遗忘明显低于S组和DS1组（P<0.05）。结论 对已发生谵妄的年轻患者，抑制疼痛可能是降低谵妄发生的基础，右美托咪定可以减少阿片类药物的使用，从而减轻其不良反应。

Effect of Dexmedetomidine Combined with Sufentanil in Young Patients with Postoperative Delirium

Objective To observe the effect of dexmedetomidine combined with sufentanil in young patients with postoperative delirium. Methods Forty young patients in ICU with postoperative delirium were randomly devided into four groups:group D, group S, group DS1 and group DS2. Recording the vital signs, the VAS, SAS score, CAM-ICU score, dosage of sufentanil and complications (breath forgetting) at different time points:T₁(0h),T₂(1h),T₃(2h),T₄(4h),T₅(8h). Results When compared with group D, the VAS, the SAS scores and the CAM-ICU score were significantly lower in other three groups at time piont of T₂, T₃, T₄, T₅ (P<0.05). The vital signs were significantly lower in other three groups at time piont of T₃, T₄, T₅ (P<0.05). Compared with S group, the VAS, the SAS scores and the CAM-ICU score were significantly lower in DS1 groups at time piont of T₃, T₄, T₅ (P<0.05). The dosage of sufentanil and respiratory forgotten times in DS2 group were significantly lower than DS1 group and S group (P<0.05). Conclusion Pain suppression might be essential to reduce the occurrence of delirium in young patients, dexmedetomidine can reduce the use of opioid drugs, to reduce the side effects.