右美托咪啶用于慢性阻塞性肺疾病患者机械通气时镇静效果分析

目的 研究右美托咪啶用于COPD患者机械通气时镇静效果.方法 入选病例来自2012年1月至2015年11月在济宁医学院附属医院重症医学科收治的慢性阻塞性肺疾病急性加重期合并呼吸衰竭行机械通气患者60例;采取前瞻随机对照方法分为2组:右美托咪定组和咪达唑仑组,每组30例,记录2组的APACHEⅡ评分、Ramsay评分等指标,比较2组患者机械通气时间,ICU住院时间,血压下降、心动过缓、谵妄发生率.结果 右美托咪啶组机械通气时间(95.00±5.00) h]与咪达唑仑组通气时间(126.00±6.00) h]相比,差异有统计学意义(t=16.65,P＜0.01);右美托咪啶组ICU住院时间(6.10±1.50)d]与咪达唑仑组ICU住院时间(8.20±1.70)d]相比,差异有统计学意义(t =9.34,P＜0.01).右美托咪啶组谵妄发生率与咪达唑仑组发生率相比,差异有统计学意义(x2=12.17,P＜0.01).血压下降和心动过缓的发生率比较,差异无统计学意义(P＞0.05).结论 右美托咪定用于COPD患者机械通气镇静治疗是有效的,它能缩短机械通气时间及住ICU时间,能降低谵妄发生率.

A analysis of efficacy of sedation with dexmedetomidine in patients with chronic obstructive pulmonary disease undergoing mechanical ventilation

Objective To investigate the sedative effects of dexmedetomidine in patients with chronic obstructive pulmonary disease undergoing mechanical ventilation.Methods Admitted cases are from sixty patients of acute exacerbation of chronic obstructive pulmonary disease with respiratory failure undergoing mechanically ventilated in the intensive care unit(ICU) from January 2012 to November 2015.For this randomized controlled trial,60 cases were were randomly divided into 2 groups:dexmedetomidine group and midazolam group,each group 30 cases,APACHE Ⅱ score,ramsay score were recorded,the time of mechanical ventilation,the time of the ICU,hypotension,bradyeardia and Delirium were compared.Results The time of mechanical ventilation in dexmedetomidine group (95.00±5.00) h] are compared with the time of mechanical ventilation in midazolam group (126.00 ± 6.00) h],t =16.65,P ＜0.01.The time of the intensive care unit in dexmedetomidine group (6.10±1.50) d] are compared with the time of the intensive care unit in midazolam group (8.20±1.70) d],t =9.34,P ＜0.01.The incidence of delirium in dexmedetomidine group compared with midazolam group has intergroup differences existed (x2 =12.17,P ＜0.01).No intergroup differences existed in the incidence of hypotension and bradyeardia (P ＞ 0.05).Conclusions Sedative effects of dexmedetomidine are effective for chronic obstructive pulmonary disease undergoing mechanical ventilation.It can reduce the time of mechanical ventilation and the ICU staying time,and decrease the incidence of delirium.