CAJ | 학술논문

目的：评估右美托咪定联合地佐辛对多发伤患者镇静镇痛的有效性及安全性。方法符合入选标准的多发伤患者60例随机分为右美托咪定联合地佐辛组（ A组）30例和咪达唑仑联合芬太尼组（ B组）30例。比较两组患者在ICU住院期间重度躁动和谵妄发生率、镇静镇痛药物费用、ICU总费用（除外手术费用）、机械通气时间和ICU 留住时间、心血管不良反应事件及呼吸抑制事件发生率等指标。结果 A组患者重度躁动和谵妄发生率明显少于B组（P＜0．05）；A组患者心血管不良反应事件和呼吸抑制事件发生率均明显少于B组（P＜0．05）；A组患者机械通气时间和ICU留住时间均比B组更少（P＜0．05）；虽然A组患者镇静镇痛药物费用明显高于B组（P＜0．05），但两组患者ICU总费用（除外手术费用）比较差异无统计学意义（P＞0．05）。结论右美托咪定联合地佐辛用于多发伤患者能获得良好的镇静镇痛效果，降低重度躁动和谵妄的发生，缩短呼吸机使用时间和ICU住院时间，且心血管不良事件和呼吸抑制事件发生率减低。
목적：평고우미탁미정연합지좌신대다발상환자진정진통적유효성급안전성。방법부합입선표준적다발상환자60례수궤분위우미탁미정연합지좌신조（ A조）30례화미체서륜연합분태니조（ B조）30례。비교량조환자재ICU주원기간중도조동화섬망발생솔、진정진통약물비용、ICU총비용（제외수술비용）、궤계통기시간화ICU 류주시간、심혈관불량반응사건급호흡억제사건발생솔등지표。결과 A조환자중도조동화섬망발생솔명현소우B조（P＜0．05）；A조환자심혈관불량반응사건화호흡억제사건발생솔균명현소우B조（P＜0．05）；A조환자궤계통기시간화ICU류주시간균비B조경소（P＜0．05）；수연A조환자진정진통약물비용명현고우B조（P＜0．05），단량조환자ICU총비용（제외수술비용）비교차이무통계학의의（P＞0．05）。결론우미탁미정연합지좌신용우다발상환자능획득량호적진정진통효과，강저중도조동화섬망적발생，축단호흡궤사용시간화ICU주원시간，차심혈관불량사건화호흡억제사건발생솔감저。
Objective To evaluate the efficacy and safety of dexmedetomidine combined with dezocine in sedation and analgesia in the patients with multiple traumas .Methods Sixty patients with multiple traumas were enrolled and randomly divided into dexmedetomidine combined with dezocine group (A group and midazolam combined with fentanyl group (B group) with thirty cases in each group. These indicators as the incidence rate of severe agitation and delirium , the cost of sedation and analgesia drug, the total cost in ICU (except for operation expenses ), the duration of mechanical ventilation , the ICU stay, the incidence rates of cardiovascular adverse events and respiratory depression events were compared between two groups .Results The incidence rates of severe agitation and delirium in group A were significantly less than group B .The incidence rates of cardiovascular adverse events and respiratory depression events in group A were significantly less than group B .The duration of mechanical ventilation and the ICU stay in Group A were shorter than group B (P<0.05).Although the cost of sedation and analgesia drug in group A was higher than that in group B (P<0.05), the total cost in ICU (except for operation expenses ) showed no significant difference ( P >0.05 ).Conclusion Dexmedetomidine combined with dezocine is effective and safe for sedation and analgesia in patients with multiple traumas , which could reduce the occurrence of severe agitation and delirium , shorten the duration of mechanical ventilation and the ICU stay , and decrease the incidence rates of cardiovascular adverse events and respiratory depression events .