CAJ | 학술논문

目的：比较瑞芬太尼+咪达唑仑、异丙酚+咪达唑仑两种镇静方法在ICU重症患者中的应用效果。方法将2014年3~12月本院ICU收治的64例重症患者随机分为治疗组和对照组，治疗组应用瑞芬太尼+咪达唑仑，对照组应用丙泊酚+咪达唑仑。比较两组的Ramsay镇静评分、Ricker镇静-躁动评分，观察两组患者治疗前及治疗后0.5、6、12 h的心率（HR）、平均动脉压（MAP）、呼吸频率（RR）等循环呼吸指标的变化。结果两组患者治疗0.5、6、12 h后的Ramsay镇静评分、Ricker镇静-躁动评分比较，差异无统计学意义（P>0.05）。两组患者治疗前HR、MAP、RR比较，差异无统计学意义（P>0.05）；治疗后各时间点HR、RR比较差异无统计学意义（P>0.05），MAP比较差异有统计学意义（P<0.05）。结论瑞芬太尼+咪达唑仑和丙泊酚+咪达唑仑的镇静效果相当，但瑞芬太尼+咪达唑仑对患者的MAP影响较小。
목적：비교서분태니+미체서륜、이병분+미체서륜량충진정방법재ICU중증환자중적응용효과。방법장2014년3~12월본원ICU수치적64례중증환자수궤분위치료조화대조조，치료조응용서분태니+미체서륜，대조조응용병박분+미체서륜。비교량조적Ramsay진정평분、Ricker진정-조동평분，관찰량조환자치료전급치료후0.5、6、12 h적심솔（HR）、평균동맥압（MAP）、호흡빈솔（RR）등순배호흡지표적변화。결과량조환자치료0.5、6、12 h후적Ramsay진정평분、Ricker진정-조동평분비교，차이무통계학의의（P>0.05）。량조환자치료전HR、MAP、RR비교，차이무통계학의의（P>0.05）；치료후각시간점HR、RR비교차이무통계학의의（P>0.05），MAP비교차이유통계학의의（P<0.05）。결론서분태니+미체서륜화병박분+미체서륜적진정효과상당，단서분태니+미체서륜대환자적MAP영향교소。
Objective To compare the effect of two sedative methods including remifentanil with midazolam and propo-folum with midazolam in critical patients in intensive care unit (ICU). Methods 64 critical patients in our hospital from March to December 2014 were randomly divided into treatment group and control group.In the treatment group, remifentanil with midazolam was applied,while in the control group,propofolum with midazolam was adopted.The Ram-say sedation score,Ricker sedation-agitation scoring (SAS) between the two groups was compared;Heart rate (HR),mean arterial pressure (MAP),breathing rate (RR) before treatment and after 0.5 h,6 h and 12 h treatment was observed. Re-sults There was no statistical difference in Ramsay sedation score and Ricker SAS after 0.5 h,6 h,and 12 h treatment (P>0.05).Before treatment,HR,MAP and RR between the two groups had no statistical difference (P>0.05);After treat-ment,HR and RR between the two groups had no statistical difference (P>0.05),but MAP between the two groups had statistical difference (P<0.05). Conclusion Sedative effect of remifentanil with midazolam and propofolum with midazo-lam is almost the same,but influence on patient’s mean arterial pressure is milder by remifentanil with midazolam.