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- 2018
右美托咪定用于口腔癌前臂皮瓣修复术后保留气管插管患者的镇静研究
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Abstract:
摘要 目的:探讨右美托咪定用于口腔癌前臂皮瓣修复术后留置经鼻气管导管患者在重症监护病房(ICU)的镇静效果及其安全性。方法:将口腔癌前臂皮瓣修复术后留置经鼻气管导管患者40例按照随机数字表法为2组:咪达唑仑组(A组,20例)、右美托咪定组(B组,20例)。分别记录2组镇静药物起效时间和药物停用后患者苏醒的时间;记录患者入ICU直至拔出气管道期间2组患者所需镇痛药物总的剂量; 记录入ICU镇静前(T0)和镇静开始后30 min(T1)、1 h(T2)、2 h(T3)、6 h(T4)、12 h(T5)和拔管后10 min(T6)各时间点Ramsay镇静评分;记录各组呼吸抑制发生率、需要治疗的心动过缓发生率、需要治疗的低血压发生率;记录谵妄发生率;记录治疗期间病死率。结果:咪达唑仑和右美托咪定均能使病人Ramsay 评分达到2~4分;停药后苏醒时间右美托咪定较咪达唑仑组快(P＜0.05);右美托咪啶组所需镇痛药总剂量少于咪达唑仑组;呼吸抑制率咪达唑仑组明显高于右美托咪啶组( P＜0.05);右美托咪定组患者并发谵妄的人数明显低于咪达唑仑组。结论:在一定剂量范围内,右美托咪啶和咪达唑仑均能满足ICU患者的镇静需要;并且右美托咪啶具有镇痛作用,减少呼吸抑制发生;另外与咪达唑仑相比,右美托咪啶可减少ICU患者的谵妄发生率
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