右美托咪啶联合奥氮平治疗心脏手术后谵妄患者的效果
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摘要
目的观察心脏术后谵妄患者应用右美托咪啶联合奥氮平治疗的效果。方法将我院83例心脏术后谵妄患者采用随机数字表法分组,对照组41例给予奥氮平口服治疗,观察组42例联合右美托咪啶静脉微量泵入,对比两组患者治疗前后多巴胺(DA)、5-羟色胺(5-HT)水平、睡眠质量、认知状态及ICU停留时间。结果观察组治疗后DA、5-HT水平及ICU停留时间、治愈时间均低于对照组,RCSQ、ACE评分高于对照组(P<0.05)。结论右美托咪啶联合奥氮平能够有效降低心脏术后谵妄患者ICU停留时间,促进认知功能恢复,其机制与调节神经递质水平及镇静深度,抑制应激反应有关。
Objective To observe the effect of dexmedetomidine combined with olanzapine in delirium patients after cardiac surgery. Methods Eighty-three delirium patients after cardiac surgery in our hospital were randomly assigned to a random number table.41 patients in the control group were treated with olanzapine orally. In the observation group,42 patients were treated with dexmedetomidine combined with olanzapine. The dopamine(DA),serotonin(5-HT)levels,sleep quality,cognitive status and ICU stay time were compared between two groups. Results The levels of DA,5-HT and ICU stay time in the observation group were lower than those in the control group. The RCSQ and ACE scores were higher than those in the control group(P<0.05). Conclusion Dexmedetomidine combined with olanzapine can effectively reduce ICU stay time in delirium patients after cardiac surgery,and promote cognitive function recovery. The mechanism is related to the regulation of neurotransmitter level and sedation depth and inhibition of stress response.
Objective To observe the effect of dexmedetomidine combined with olanzapine in delirium patients after cardiac surgery. Methods Eighty-three delirium patients after cardiac surgery in our hospital were randomly assigned to a random number table.41 patients in the control group were treated with olanzapine orally. In the observation group,42 patients were treated with dexmedetomidine combined with olanzapine. The dopamine(DA),serotonin(5-HT)levels,sleep quality,cognitive status and ICU stay time were compared between two groups. Results The levels of DA,5-HT and ICU stay time in the observation group were lower than those in the control group. The RCSQ and ACE scores were higher than those in the control group(P<0.05). Conclusion Dexmedetomidine combined with olanzapine can effectively reduce ICU stay time in delirium patients after cardiac surgery,and promote cognitive function recovery. The mechanism is related to the regulation of neurotransmitter level and sedation depth and inhibition of stress response.
引文
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10.解鑫隆,徐朝军,尹晓清,等.醒脑静辅助奥氮平治疗主动脉夹层腔内隔绝术后谵妄45例[J].西部中医药,2018,31(10):79-82.
11.王丽竹,李茜,兰美娟.浅镇静治疗在危重病患者中的执行现状和对策[J].中华急诊医学杂志,2018,27(5):577-580.
12.蔡英华,许正红,黄琴红,等.镇痛镇静调控方案对心脏外科术后患者ICU谵妄的影响[J].中国实用护理杂志,2018,34(9):652-655.
13.郑艳会,邵丽娜.盐酸右美托咪定对老年髋部骨折患者术后谵妄的影响[J].武警医学,2018,29(3):270-273.
14.邢乃姣,王梅,孙晓娜,等.右美托咪啶联合奥氮平在心脏术后ICU谵妄的疗效评价[J].精神医学杂志,2018,31(3):214-217.
2.邹凯,袁菁,易峰,等.地西泮联合奥氮平治疗震颤谵妄伴激越行为的临床研究[J].中华行为医学与脑科学杂志,2018,27(10):911-914.
3.生伟,栾天,池一凡,等.右美托咪定对非体外循环冠状动脉旁路移植患者术后谵妄的影响[J].心肺血管病杂志,2018,37(11):1007-1009,1013.
4.汤铂,王小亭,陈文劲,等.重症患者谵妄管理专家共识[J].中华内科杂志,2019,58(2):108-118.
5.张雪艳,邵换璋,董鑫,等.ICU谵妄评估工具的研究进展[J].中华危重病急救医学,2018,30(4):381-384.
6.杨富,方芳,陈兰,等.重症监护室患者康复评估工具的研究进展[J].解放军护理杂志,2018,35(7):37-40.
7.伍业光,张国兵,张春林,等.65例老年期谵妄的预后分析[J].广西医科大学学报,2007,24(5):806-807.
8.吴传芹,朱艳萍,李国宏.ICU患者谵妄的发生率及危险因素分析[J].第三军医大学学报,2018,40(11):1038-1043.
9.孙丹丹,柴文昭,郭海凌,等.不同类型谵妄在机械通气患者中的发生现状及临床结局比较[J].中华护理杂志,2018,53(7):778-782.
10.解鑫隆,徐朝军,尹晓清,等.醒脑静辅助奥氮平治疗主动脉夹层腔内隔绝术后谵妄45例[J].西部中医药,2018,31(10):79-82.
11.王丽竹,李茜,兰美娟.浅镇静治疗在危重病患者中的执行现状和对策[J].中华急诊医学杂志,2018,27(5):577-580.
12.蔡英华,许正红,黄琴红,等.镇痛镇静调控方案对心脏外科术后患者ICU谵妄的影响[J].中国实用护理杂志,2018,34(9):652-655.
13.郑艳会,邵丽娜.盐酸右美托咪定对老年髋部骨折患者术后谵妄的影响[J].武警医学,2018,29(3):270-273.
14.邢乃姣,王梅,孙晓娜,等.右美托咪啶联合奥氮平在心脏术后ICU谵妄的疗效评价[J].精神医学杂志,2018,31(3):214-217.