临床外科杂志
臨床外科雜誌
림상외과잡지
JOURNAL OF CLINICAL SURGERY
2014年
12期
895-898
,共4页
舒芬太尼%芬太尼%咪唑安定%镇静镇痛%机械通气
舒芬太尼%芬太尼%咪唑安定%鎮靜鎮痛%機械通氣
서분태니%분태니%미서안정%진정진통%궤계통기
sufentanil%fentanyl%midazolam%sedationandanalgesia%mechanicallyven-tilation
目的:评价单用或联合应用舒芬太尼在重症监护病房机械通气患者镇痛镇静治疗中的效应和安全性。方法160例ICU需行机械通气患者随机分为四组,分别予舒芬太尼、舒芬太尼联合咪唑安定、舒芬太尼联合右美托咪定、芬太尼镇痛镇静治疗。观察用药前后的面部表情评分法(FPS)、Ramsay评分法(RS)和生命体征的变化,统计比较不同治疗方案对器官功能的影响和不良反应的差异。结果与治疗前相比,四组FPS评分明显下降并维持在3分左右(P<0.001),RS显著升高(P<0.001)。在30 min,1 h,6 h时间点,舒芬太尼联合应用咪唑安定或右美托咪定患者RS分值高于单独应用舒芬太尼和芬太尼患者,差异有统计学意义(P<0.05)。与治疗前相比,四组患者治疗后肺功能指标(PaCO2,血乳酸)、肝功能(AST)、肾功能(肌酐)均降低(P<0.05)。治疗后芬太尼组呼吸频率高于其他三组,差异有统计学意义(P<0.05)。联合应用方案舒芬太尼应用总量明显低于单用组(P<0.05)。四组不良反应发生率差异无统计学意义(P<0.05)。结论舒芬太尼镇痛镇静效能强,生理干扰小,无严重不良反应,联合用药可显著减少舒芬太尼的用量,并改善其对呼吸的抑制作用,值得推广应用。
目的:評價單用或聯閤應用舒芬太尼在重癥鑑護病房機械通氣患者鎮痛鎮靜治療中的效應和安全性。方法160例ICU需行機械通氣患者隨機分為四組,分彆予舒芬太尼、舒芬太尼聯閤咪唑安定、舒芬太尼聯閤右美託咪定、芬太尼鎮痛鎮靜治療。觀察用藥前後的麵部錶情評分法(FPS)、Ramsay評分法(RS)和生命體徵的變化,統計比較不同治療方案對器官功能的影響和不良反應的差異。結果與治療前相比,四組FPS評分明顯下降併維持在3分左右(P<0.001),RS顯著升高(P<0.001)。在30 min,1 h,6 h時間點,舒芬太尼聯閤應用咪唑安定或右美託咪定患者RS分值高于單獨應用舒芬太尼和芬太尼患者,差異有統計學意義(P<0.05)。與治療前相比,四組患者治療後肺功能指標(PaCO2,血乳痠)、肝功能(AST)、腎功能(肌酐)均降低(P<0.05)。治療後芬太尼組呼吸頻率高于其他三組,差異有統計學意義(P<0.05)。聯閤應用方案舒芬太尼應用總量明顯低于單用組(P<0.05)。四組不良反應髮生率差異無統計學意義(P<0.05)。結論舒芬太尼鎮痛鎮靜效能彊,生理榦擾小,無嚴重不良反應,聯閤用藥可顯著減少舒芬太尼的用量,併改善其對呼吸的抑製作用,值得推廣應用。
목적:평개단용혹연합응용서분태니재중증감호병방궤계통기환자진통진정치료중적효응화안전성。방법160례ICU수행궤계통기환자수궤분위사조,분별여서분태니、서분태니연합미서안정、서분태니연합우미탁미정、분태니진통진정치료。관찰용약전후적면부표정평분법(FPS)、Ramsay평분법(RS)화생명체정적변화,통계비교불동치료방안대기관공능적영향화불량반응적차이。결과여치료전상비,사조FPS평분명현하강병유지재3분좌우(P<0.001),RS현저승고(P<0.001)。재30 min,1 h,6 h시간점,서분태니연합응용미서안정혹우미탁미정환자RS분치고우단독응용서분태니화분태니환자,차이유통계학의의(P<0.05)。여치료전상비,사조환자치료후폐공능지표(PaCO2,혈유산)、간공능(AST)、신공능(기항)균강저(P<0.05)。치료후분태니조호흡빈솔고우기타삼조,차이유통계학의의(P<0.05)。연합응용방안서분태니응용총량명현저우단용조(P<0.05)。사조불량반응발생솔차이무통계학의의(P<0.05)。결론서분태니진통진정효능강,생리간우소,무엄중불량반응,연합용약가현저감소서분태니적용량,병개선기대호흡적억제작용,치득추엄응용。
Objective To evaluate the effects and security of single or combined sufentanil application on sedation and analgesia for mechanically ventilated patients in intensive care unit(ICU).Method A total of 160 ICU patients with mechanical ventilation were randomly allocated into four groups:sufentanil group,sufentanil plus midazolam group,sufentanil plus dexmedetomidine group and fentanyl group.Facial pain scale(FPS),Ramsay score and vital signs were employed to assess the effects of different therapies on organ functions and adverse reactions.Result After the treatment,FPS in all groups were significantly decreased and maintained around 3 points.Ramsay scores were significantly increased(P <0.001)and the score in group given sufentanil combined with midazolam or dexmedetomidine at the time points of30 min,1 h,6 h were even higher.Compared with the preoperative data,indicators of lung function(PaCO2and blood lactic acid),liver function(AST)and renal function(Cr)were decreased in all groups(P <0.05).Respiratory rate in the fentanyl group was significantly higher than the others.Total consumption ofsufentanil in group with combined sufentanil application was significantly lower.No significant differencesin adverse reactions were noticed among the groups(P >0.05).Conclusion For mechanically ventilatedpatients,sufentanil has efficient sedative and analgesic effects with less physiological interference and severe adverse reactions.Combined application is beneficial in decreasing total sufentanil consumption andinhibition to respiratory system,which is worthy of being spread.