当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2013年
22期
3-4,5
,共3页
右美托咪定%镇静%神经外科%术后%重症监护
右美託咪定%鎮靜%神經外科%術後%重癥鑑護
우미탁미정%진정%신경외과%술후%중증감호
Dexmedetomidine%Sedation%Neurological surgery%Postoperative%Intensive care
目的探讨右美托咪定对神经外科术后患者镇静治疗的应用价值。方法以清远市人民医院2011年9月-2012年9月间，收治的神经外科术后130例患者为研究对象，随机将患者分为A组和B组。其中A组采用右美托咪定镇静，B组采用传统的咪达唑仑镇静。比较两组患者ICU拔管时间、意外拔管率、NICU停留时间、镇痛降压药物的剂量等指标。结果 A组患者的拔管时间较B组短[（16.4±15.6) h vs (22.5±18.5)h,P=0.04]，A组应用的镇痛药物剂量比B组减少[（0.6±0.2) mg/d vs （0.8±0.3) mg，P<0.01]，降压药物剂量减少[(116.6±84.3)mg vs (146.9±85.3)mg，P=0.04]。A组患者镇静状态的神志更接近停药后水平（P<0.01）。但两组在NICU生存率、意外拔管几率、呼吸机相关肺炎发生率、NICU停留时间等方面，未见显著差异。结论右美托咪定可有效应用于神经外科术后的镇静治疗，有利于减少拔管时间，减少镇痛药物及降压药物剂量，对患者的神志判断影响相对较小。
目的探討右美託咪定對神經外科術後患者鎮靜治療的應用價值。方法以清遠市人民醫院2011年9月-2012年9月間，收治的神經外科術後130例患者為研究對象，隨機將患者分為A組和B組。其中A組採用右美託咪定鎮靜，B組採用傳統的咪達唑崙鎮靜。比較兩組患者ICU拔管時間、意外拔管率、NICU停留時間、鎮痛降壓藥物的劑量等指標。結果 A組患者的拔管時間較B組短[（16.4±15.6) h vs (22.5±18.5)h,P=0.04]，A組應用的鎮痛藥物劑量比B組減少[（0.6±0.2) mg/d vs （0.8±0.3) mg，P<0.01]，降壓藥物劑量減少[(116.6±84.3)mg vs (146.9±85.3)mg，P=0.04]。A組患者鎮靜狀態的神誌更接近停藥後水平（P<0.01）。但兩組在NICU生存率、意外拔管幾率、呼吸機相關肺炎髮生率、NICU停留時間等方麵，未見顯著差異。結論右美託咪定可有效應用于神經外科術後的鎮靜治療，有利于減少拔管時間，減少鎮痛藥物及降壓藥物劑量，對患者的神誌判斷影響相對較小。
목적탐토우미탁미정대신경외과술후환자진정치료적응용개치。방법이청원시인민의원2011년9월-2012년9월간，수치적신경외과술후130례환자위연구대상，수궤장환자분위A조화B조。기중A조채용우미탁미정진정，B조채용전통적미체서륜진정。비교량조환자ICU발관시간、의외발관솔、NICU정류시간、진통강압약물적제량등지표。결과 A조환자적발관시간교B조단[（16.4±15.6) h vs (22.5±18.5)h,P=0.04]，A조응용적진통약물제량비B조감소[（0.6±0.2) mg/d vs （0.8±0.3) mg，P<0.01]，강압약물제량감소[(116.6±84.3)mg vs (146.9±85.3)mg，P=0.04]。A조환자진정상태적신지경접근정약후수평（P<0.01）。단량조재NICU생존솔、의외발관궤솔、호흡궤상관폐염발생솔、NICU정류시간등방면，미견현저차이。결론우미탁미정가유효응용우신경외과술후적진정치료，유리우감소발관시간，감소진통약물급강압약물제량，대환자적신지판단영향상대교소。
Objective To explore the use of dexmetomidine in the sedation treatment after neurological surgery in the neurological intensive care unit(NICU). Methods During September of 2011 to September of 2012, 120 patients after neurological surgerys who the Qingyuan NCIU conducted were enrolled in the research. They were divided into two groups randomly. Group A included the patients who accepted the Dexmedetomidine as sedation treatment, and group B accepted the traditional midazolam. The time of tracheal intubation drawing, the incidence of unexpected tube drawing, the stay-time of NICU, the doses of analgesic and hypotensor were compared as the measurements. Results The time of the tracheal intubation drawing was shorter in group A[(16.4±15.6)h vs (22.5±18.5) h,P=0.04]. Less analgesic and hypotensor were needed in group A (0.6±0.2)mg/d vs (0.8±0.3)mg,P<0.01 and (116.6±84.3) mg vs (146.9±85.3) mg(P=0.04). The patients in group A had better status of consciousness which were more likely approaching to the status without sedation treatment. But there was no signiifcant statistical difference in the aspect of survival rate in NICU, the incidence of unexpected tube drawing, the rate of ventilator-associated pneumonia, the stay-time of NICU between two groups. Conclusion Dexmedetomidine could apply to the sedation treatment after neurological surgery effectively. That drug may associated with less time of the tracheal intubation drawing, less need of analgesic and hypotensor and smaller inlfuence on the status of consciousness.
