CAJ | 학술논문

目的：探讨右美托咪定对心脏瓣膜置换手术后重症监护患者的镇静效果及安全性。方法选择80例心脏瓣膜置换术后入住ICU患者,分为对照组和实验组,分别采用咪达唑仑和右美托咪定进行镇静。监测两组患者镇静前后HR、RR、MAP、SpO2、VAS评分、Ramsay评分、达到镇静所需时间、停药后苏醒时间、芬太尼用量及不良反应发生率。结果镇静后,实验组的HR、MAP明显低于对照组(P<0．05),SpO2明显高于对照组(P<0．05),但RR比较差异无统计学意义(P>0．05)。镇静后,两组患者VAS评分、Ramsay评分比较差异有统计学意义(P<0．05)。实验组患者达到镇静所需时间、停药后苏醒时间均明显低于对照组(P<0．05),实验组芬太尼用量明显少于对照组(P<0．05)。实验组患者呕吐、谵妄发生率明显低于对照组(P<0．05),实验组患者心动过缓、低血压发生率明显高于对照组(P<0．05)。结论右美托咪定对心脏瓣膜置换手术后重症监护患者有镇静作用,呕吐、谵妄发生率低。
목적：탐토우미탁미정대심장판막치환수술후중증감호환자적진정효과급안전성。방법선택80례심장판막치환술후입주ICU환자,분위대조조화실험조,분별채용미체서륜화우미탁미정진행진정。감측량조환자진정전후HR、RR、MAP、SpO2、VAS평분、Ramsay평분、체도진정소수시간、정약후소성시간、분태니용량급불량반응발생솔。결과진정후,실험조적HR、MAP명현저우대조조(P<0．05),SpO2명현고우대조조(P<0．05),단RR비교차이무통계학의의(P>0．05)。진정후,량조환자VAS평분、Ramsay평분비교차이유통계학의의(P<0．05)。실험조환자체도진정소수시간、정약후소성시간균명현저우대조조(P<0．05),실험조분태니용량명현소우대조조(P<0．05)。실험조환자구토、섬망발생솔명현저우대조조(P<0．05),실험조환자심동과완、저혈압발생솔명현고우대조조(P<0．05)。결론우미탁미정대심장판막치환수술후중증감호환자유진정작용,구토、섬망발생솔저。
Objective To investigate the sedative effect and safety of dexmedetomidine on patients in intensive care unit after cardiac valve replacement. Methods 80 ICU patients after cardiac valve replacement were randomly di-vided into control group and experiment group,and the two groups were sedated with midazolam and dexmedetomidine respectively. The HR,RR,MAP,SpO2 ,VAS score,Ramsay score,sedation onset time,awakening time,sufentanil dos-age and adverse effects were compared between the two groups. Results After sedation,the HR,MAP of experiment group were significantly lower than those of control group (P<0. 05),and SpO2 was significantly higher than that of control group (P<0. 05). There were significant differences in VAS score and Ramsay score between the two groups (P<0. 05). The sedation onset time and awakening time of experiment group were significantly shorter than those of control group (P<0. 05),and fentanyl dosage of experiment group was significantly lower than that of control group ( P<0. 05). The incidences of vomiting and delirium in experiment group were significantly lower than those of control group ( P<0. 05 ) , and the incidences of bradycardia and hypotension of experiment group were significantly higher than those of control group (P<0. 05). Conclusion Dexmedetomidine has sedative effect on patients in intensive care unit after cardiac valve replacement with low incidences of vomiting and delirium.