咪达唑仑联合芬太尼对ICU慢性阻塞性肺疾病机械通气患者的镇静效果评价

目的 评价咪达唑仑联合芬太尼对ICU慢性阻塞性肺疾病（COPD）机械通气患者的镇静效果.方法 选择梧州市工人医院2012年3月至2013年3月ICU需要机械通气的COPD患者62例随机分为两组,对照组31例患者仅给予咪达唑仑,观察组31例患者给予咪达唑仑联合芬太尼联合镇静,采用Ramsay镇静评分对两组患者治疗前后镇静效果进行评价,同时比较两组治疗前后血流动力学指标及呼吸动力学指标变化.结果 观察组用药后镇静效果好于对照组,麻醉药物用量少于对照组,两组比较差异具有统计学意义（P＜0.05）.两组治疗后循环与呼吸动力学指标均明显改善,两组镇静前与镇静后循环与呼吸动力学指标比较差异无统计学意义（P＞0.05）.结论 咪达唑仑联合芬太尼用于ICU慢性阻塞性肺疾病机械通气患者可提高镇静效果,同时可减少麻醉药物的用量,是安全有效的镇静方法.

Evaluation of sedative effect of midazolam combined with fentanyl on chronic obstructive pulmonary disease patients with mechanical ventilation in ICU

Objective To evaluate the sedative effect of midazolam combined with fentanyl on chronic obstructive pulmonary disease （COPD） patients with mechanical ventilation in ICU.Methods Sixty-two patients with mechanical ventilation in ICU from from March,2012 to March,2013 were randomly divided into two groups,each of 31 patients.Patients in the control group were given midazolam,and patients in the observation group were given midazolam combined with fentanyl.The sedative effect of two groups before and after treatment was evaluated according to Ramsay sedation score,at the same time,and hemodynamic and respiratory dynamics indicators of two groups before and after treatment was compared.Results The sedative effect of observation group was better than that in control group,dosage of anesthetic was less than that in control group （P＜0.05）.The hemodynamic and respiratory dynamics indicators of two groups after treatment were significantly improved,and the hemodynamic and respiratory dynamics indicators of two groups before and after treatment had no significant difference.Conclusion Midazolam combined with fentanyl used in chronic obstructive pulmonary disease patients with mechanical ventilation in ICU can improve the effect of sedation and reduce the dosage of anesthetic,and it is a safe and effective method of sedation.