右美托咪定联合瑞芬太尼与咪达唑仑联合芬太尼在ICU谵妄发生率的比较
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摘要
目的比较重症医学科(ICU)患者采用右美托咪定联合瑞芬太尼与咪达唑仑联合芬太尼所致谵妄的发生率。方法选取2015年6月～2017年10月我科收治的78例患者,按照随机数字表法分为右美托咪定联合瑞芬太尼组(YRF组)和咪达唑仑联合芬太尼组(MF组)各39例,分别给予右美托咪定联合瑞芬太尼与咪达唑仑联合芬太尼镇静镇痛。比较两组谵妄的发生率。结果两组镇静评分差异无统计学意义(P>0.05)。右美托咪定联合瑞芬太尼组NRS疼痛评分明显低于咪达唑仑联合芬太尼组。右美托咪定联合瑞芬太尼致躁动、谵妄、人机对抗发生率明显低于咪达唑仑联合芬太尼组(P<0.05)。结论 ICU谵妄是一组常见的重症监护病房临床综合征,使用右美托咪定联合瑞芬太尼镇静镇痛,谵妄发生率较低。
Objective To compare the incidence of delirium induced by dexmetomidine combined with rifentanil and midazolam combined with fentanyl in ICU patients. Methods Select in June 2015 to October 2017 of 78 patients admitted in our department,according to the random number table method is divided into the right mi fixed joint,fentanyl group(YRF)and midazolam fentanyl group(MF),39 cases were given the right holder mi fixed joint,fentanyl and midazolam combined fentanyl sedation analgesia. The incidence of delirium in the two groups was compared. Results There was no significant difference in sedation score between the two groups(P>0.05). The NRS pain score of dexmedetomidine combined with remifentanil was significantly lower than that of midazolam combined with fentanyl. The incidence of restlessness,delirium and man-machine antagonism induced by dex combined with remifentanil was significantly lower than that of midazolam combined with fentanyl(P<0.05). Conclusion ICU delirium is a common clinical syndrome in ICU. The incidence of delirium is low when using dexmedetomidine combined with remifentanil for sedation and analgesia.
Objective To compare the incidence of delirium induced by dexmetomidine combined with rifentanil and midazolam combined with fentanyl in ICU patients. Methods Select in June 2015 to October 2017 of 78 patients admitted in our department,according to the random number table method is divided into the right mi fixed joint,fentanyl group(YRF)and midazolam fentanyl group(MF),39 cases were given the right holder mi fixed joint,fentanyl and midazolam combined fentanyl sedation analgesia. The incidence of delirium in the two groups was compared. Results There was no significant difference in sedation score between the two groups(P>0.05). The NRS pain score of dexmedetomidine combined with remifentanil was significantly lower than that of midazolam combined with fentanyl. The incidence of restlessness,delirium and man-machine antagonism induced by dex combined with remifentanil was significantly lower than that of midazolam combined with fentanyl(P<0.05). Conclusion ICU delirium is a common clinical syndrome in ICU. The incidence of delirium is low when using dexmedetomidine combined with remifentanil for sedation and analgesia.
引文
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2.Short J.Use of dexmedetomindine for primary sedation in a general in-tensive care unit[J].Drugs,2000,59(2):263-268.
3.邱海波,黄青青.中国重症加强治疗病房患者镇痛和镇静治疗指南(2006)[J].中华外科杂志,2006,44(17):1158-1166.
4.汪彦,贾超.ICU患者应用右美托咪定抗焦虑作用的临床观察[J].实用医院临床杂志,2013,10(6):50-52.
5.Bhana N,Goa KL,McClellan KJ.Dexmedetomidine[J].Drugs,2000,59(2),263-268.
6.Richard RR,Yahya S,Paula MB.Dexmedetomidine vs.Midazolam for sedation of Critically ill patient:a randomized trial[J].Journal of the American Medical Asscciation,2009,(05):489-499.
7.Bums A,Gallagley A,Byme J.Delirium[J].J Neurol Neurosurg Psychiatry,2004,75(3):362-367.
8.Devulder J.Flupirtine in pain management:pharmacological properties and clinical use.[J]CNS Drugs,2010,24(10):867-881.
9.Nair AS,Ubale P.Flupirtine:A Narrative Review of Its Role in Acute and Chronic Pain Management.Med One,2017,2:e170006.
9.Zhan X,Long Y,Zhan X,et al.Consideration of Statistical vs.Biological Significances for Omics Data-Based Pathway Network Analysis.Med One,2017,1:e170002.
10.Liu C,Gershon ES.The Path from Basic Research to Clinical Practice.J Psychiatry Brain Sci.2017,2(2):5.