中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
3期
295-298
,共4页
右美托咪啶%咪达唑仑%机械通气%呼吸%循环
右美託咪啶%咪達唑崙%機械通氣%呼吸%循環
우미탁미정%미체서륜%궤계통기%호흡%순배
Dexmedetomidine%Midazolam%Mechanical ventilation%Respiration%Circulation
目的 比较右美托咪啶(DEX)和咪达唑仑对机械通气患者呼吸和循环的影响.方法 将内科重症监护病房机械通气镇静的62例患者随机(随机数字法)分为两组,咪达唑仑组38例和DEX组24例.咪达唑仑组静脉注射咪达唑仑0.05 mg/kg负荷量,注药时间为30～60 s,再以0.05～0.15 mg/(kg·h)持续静脉泵入；DEX组在超过10 min内,给予负荷量1.0μg/kg,之后注射泵0.2～0.7.μg/(kg·h)持续静脉泵入.以Ramsay分级,维持理想的镇静深度Ⅲ～Ⅳ级,比较观察两组患者镇静前、镇静后10 min、30 min、2h的心率以及平均动脉压、呼吸频率、脉搏血氧饱和度.结果 2种药物镇静后呼吸频率、心率较镇静前下降,差异具有统计学意义(P＜0.05),而血氧饱和度较镇静前升高,差异具有统计学意义(P＜0.05)；DEX组镇静前后血压差异无统计学意义,而咪达唑仑组镇静前血压为(83.11±12.95) mm Hg(1mm Hg=0.133 kPa),镇静后10min为(74.13±12.50) mm Hg,差异具有统计学意义(P＜0.05).而镇静后30 min、2h血压分别为(80.53 +12.93) mm Hg、(82.47±12.15) mm Hg,差异无统计学意义.结论 DEX和咪达唑仑对机械通气患者呼吸影响相当,DEX对循环的影响较咪达唑仑小.
目的 比較右美託咪啶(DEX)和咪達唑崙對機械通氣患者呼吸和循環的影響.方法 將內科重癥鑑護病房機械通氣鎮靜的62例患者隨機(隨機數字法)分為兩組,咪達唑崙組38例和DEX組24例.咪達唑崙組靜脈註射咪達唑崙0.05 mg/kg負荷量,註藥時間為30～60 s,再以0.05～0.15 mg/(kg·h)持續靜脈泵入；DEX組在超過10 min內,給予負荷量1.0μg/kg,之後註射泵0.2～0.7.μg/(kg·h)持續靜脈泵入.以Ramsay分級,維持理想的鎮靜深度Ⅲ～Ⅳ級,比較觀察兩組患者鎮靜前、鎮靜後10 min、30 min、2h的心率以及平均動脈壓、呼吸頻率、脈搏血氧飽和度.結果 2種藥物鎮靜後呼吸頻率、心率較鎮靜前下降,差異具有統計學意義(P＜0.05),而血氧飽和度較鎮靜前升高,差異具有統計學意義(P＜0.05)；DEX組鎮靜前後血壓差異無統計學意義,而咪達唑崙組鎮靜前血壓為(83.11±12.95) mm Hg(1mm Hg=0.133 kPa),鎮靜後10min為(74.13±12.50) mm Hg,差異具有統計學意義(P＜0.05).而鎮靜後30 min、2h血壓分彆為(80.53 +12.93) mm Hg、(82.47±12.15) mm Hg,差異無統計學意義.結論 DEX和咪達唑崙對機械通氣患者呼吸影響相噹,DEX對循環的影響較咪達唑崙小.
목적 비교우미탁미정(DEX)화미체서륜대궤계통기환자호흡화순배적영향.방법 장내과중증감호병방궤계통기진정적62례환자수궤(수궤수자법)분위량조,미체서륜조38례화DEX조24례.미체서륜조정맥주사미체서륜0.05 mg/kg부하량,주약시간위30～60 s,재이0.05～0.15 mg/(kg·h)지속정맥빙입；DEX조재초과10 min내,급여부하량1.0μg/kg,지후주사빙0.2～0.7.μg/(kg·h)지속정맥빙입.이Ramsay분급,유지이상적진정심도Ⅲ～Ⅳ급,비교관찰량조환자진정전、진정후10 min、30 min、2h적심솔이급평균동맥압、호흡빈솔、맥박혈양포화도.결과 2충약물진정후호흡빈솔、심솔교진정전하강,차이구유통계학의의(P＜0.05),이혈양포화도교진정전승고,차이구유통계학의의(P＜0.05)；DEX조진정전후혈압차이무통계학의의,이미체서륜조진정전혈압위(83.11±12.95) mm Hg(1mm Hg=0.133 kPa),진정후10min위(74.13±12.50) mm Hg,차이구유통계학의의(P＜0.05).이진정후30 min、2h혈압분별위(80.53 +12.93) mm Hg、(82.47±12.15) mm Hg,차이무통계학의의.결론 DEX화미체서륜대궤계통기환자호흡영향상당,DEX대순배적영향교미체서륜소.
Objective To compare the effects of dexmedetomidine on the respiration and circulation with midazolam in mechanically ventilated patients.Methods A total of 62 patients supported with mechanical ventilation in medical intensive care unit were randomly (random number) divided into two groups:midazolam group ( group A,n =38 ) and dexmedetomidine group ( B group,n =24).The patients in group A were intravenously administered with midazolam in bolus dose of 0.05 mg/kg given over 30 - 60 s,and then maintained with 0.05 -0.15 mg/(kg ·h) by venous pump.The patients in group B were intravenously administered dexmedetomidine in bolus dose of 1.0 μg/kg given in more than 10 min,and then maintained with 0.2 - 0.7 μg/( kg · h) by venous pump.When the patients' sedation degree were required to reach Ⅲ - Ⅳ Ramsay Grade,the heart rate,mean arterial pressure,respiratory rate and SpO2 before sedation were compared with those 10 min,30 min and 2 hours after sedation between two groups.Results Respiratory rate or heart rate after sedation significantly decreased compared with those of presedation ( P ＜ 0.05 ).Blood pressure after sedation did not decrease significantly compared with that of presedation in Dexmedetomidine group.In midazolam group,blood pressure was (83.11 ± 12.95 ) mm Hg before sedation,and there was a significant decrease to (74.13 + 12.50) mm Hg in 10 min after sedation (P ＜ 0.05 ),while there were no significant difference between ( 80.53 + 12.93 ) mm Hg 30 min after sedaton and (82.47 ± 12. 15 ) mm Hg 2 hours after sedation.Conclusions There is no difference in effects on respiration of mechanically ventilated patients between dexmedetomidine and midazolam,and the effect of dexmedetomidine on circulation was less than that of midazolam.
