右美托咪定对截肢术后发生谵妄的疗效观察(1)
摘 要：目的 观察右美托咪定治疗截肢术后发生谵妄的临床疗效，评价其应用价值。方法 将我科2015年8月～2016年8月80例截肢术后发生谵妄的患者按随机数字表法随机分为A、B两组，各40例。A组采用氟哌啶醇治疗，B组采用盐酸右美托咪定治疗。在治疗前(T0)及治疗后1～3 d(T1～T3)同时间点分别记录患者的心率、呼吸频率、血压及重症谵妄筛查量表(ICDSC)总分值，同时观察两组患者不良反应发生情况。结果 两组患者随治疗的进行心率和呼吸频率均逐渐降低，组间差异无统计学意义(P>0.05)，MAP基本维持在正常水平，两组ICDSC总分均逐渐降低，在治疗3 d后B组ICDSC总分显著低于A组，差异具有统计学意义(P<0.05)；B组不良反应发生情况明显低于A组，差异有统计学意义(P<0.05)。结论 右美托咪定能有效改善患者截肢术后谵妄状态，不良反应少，疗效确切，值得临床推广应用。
关键词：右美托咪定；截肢术；谵妄；氟哌啶醇
中图分类号：R685 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.043
, 百拇医药
文章编号：1006-1959(2018)04-0123-02
Abstract：Objective To observe the clinical effect of dexmetomidine on delirium after amputation and evaluate its clinical value.Methods From August 2015 to August 2016，80 patients with delirium after amputation and were randomly divided into A，B two groups(40 cases each)according to the random digital table method.A group were treated with haloperidol and B group were treated with dexmetidine and hydrochloride.The heart rate，respiratory rate，blood pressure and ICDSC scores were recorded before treatment (T0) and 1～3 d after treatment(T1～T3)respectively.At the same time，adverse reactions occurred.Results The heart rate and respiratory rate of two groups of patients decreased gradually with the treatment，but there was no significant difference between the two groups (P>0.05).MAP maintained at normal levels，and the ICDSC scores decreased gradually in both groups.After 3 d of treatment The total score of ICDSC in group B was significantly lower than that in group A，the difference was statistically significant(P<0.05).The incidence of adverse reactions in group B was significantly lower than that in group A，the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can effectively improve delirium status after amputation in patients with less adverse reactions， the curative effect is exact and worthy of clinical application.
, 百拇医药
Key words：Dexmedetomidine；Amputation；Delirium；Haloperidol
截肢术常用于重大创伤、骨肿瘤、动脉血栓形成、严重感染等疾病，术后谵妄是其常见的并发症之一[1]，与谵妄相关的医院死亡率为25%～33%[2]。既往研究发现右美托咪定不仅可以预防而且能够治疗与ICU相关的谵妄[3]，故本研究通过应用右美托咪定对截肢术后发生谵妄患者进行镇静镇痛治疗，以探讨其对截肢术后发生谵妄患者的疗效，现报告如下。
1 资料与方法
1.1 一般资料 选取石河子市人民医院骨二科2015年8月～2016年8月截肢术后发生谵妄的患者80例。本研究经我院伦理委员会批准，纳入标准：①年龄大于18岁并小于70岁；②截肢为单一肢体。排除标准：①心率低于70次/min；②Q-T间期异常者；③室性心律失常；④不签署知情同意书者。按随机数字表法将所有患者分为两组，各40例。A组中男26例，女14例，年龄19～68岁，平均年龄(42.31±15.42)岁。B组患者中男30例，女10例，年龄20～70岁，平均年龄(45.93±16.34)岁。两组患者性别、年龄比较差异无统计学意义(P>0.05)，临床可比。
1.2 方法 A组患者确诊谵妄后及时给予氟哌啶醇注射液(徐州莱恩药业有限公司，国药准字H32022182；肌内注射：5～10 mg/次，2～3次/d)治疗；B组患者在确诊谵妄后及时给予盐酸右美托咪定注射液(国药准字H20090248。靜脉微量泵泵入，负荷量为0.5 μ/kg，输注时间10 min；维持剂量在0.3～0.5 μg/(kg·h)治疗，所有受试对象生命体征平稳，意识达到嗜睡状态为治疗目标。, http://www.100md.com(陶晶 王鑫 黄擘)
关键词：右美托咪定；截肢术；谵妄；氟哌啶醇
中图分类号：R685 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.043
, 百拇医药
文章编号：1006-1959(2018)04-0123-02
Abstract：Objective To observe the clinical effect of dexmetomidine on delirium after amputation and evaluate its clinical value.Methods From August 2015 to August 2016，80 patients with delirium after amputation and were randomly divided into A，B two groups(40 cases each)according to the random digital table method.A group were treated with haloperidol and B group were treated with dexmetidine and hydrochloride.The heart rate，respiratory rate，blood pressure and ICDSC scores were recorded before treatment (T0) and 1～3 d after treatment(T1～T3)respectively.At the same time，adverse reactions occurred.Results The heart rate and respiratory rate of two groups of patients decreased gradually with the treatment，but there was no significant difference between the two groups (P>0.05).MAP maintained at normal levels，and the ICDSC scores decreased gradually in both groups.After 3 d of treatment The total score of ICDSC in group B was significantly lower than that in group A，the difference was statistically significant(P<0.05).The incidence of adverse reactions in group B was significantly lower than that in group A，the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can effectively improve delirium status after amputation in patients with less adverse reactions， the curative effect is exact and worthy of clinical application.
, 百拇医药
Key words：Dexmedetomidine；Amputation；Delirium；Haloperidol
截肢术常用于重大创伤、骨肿瘤、动脉血栓形成、严重感染等疾病，术后谵妄是其常见的并发症之一[1]，与谵妄相关的医院死亡率为25%～33%[2]。既往研究发现右美托咪定不仅可以预防而且能够治疗与ICU相关的谵妄[3]，故本研究通过应用右美托咪定对截肢术后发生谵妄患者进行镇静镇痛治疗，以探讨其对截肢术后发生谵妄患者的疗效，现报告如下。
1 资料与方法
1.1 一般资料 选取石河子市人民医院骨二科2015年8月～2016年8月截肢术后发生谵妄的患者80例。本研究经我院伦理委员会批准，纳入标准：①年龄大于18岁并小于70岁；②截肢为单一肢体。排除标准：①心率低于70次/min；②Q-T间期异常者；③室性心律失常；④不签署知情同意书者。按随机数字表法将所有患者分为两组，各40例。A组中男26例，女14例，年龄19～68岁，平均年龄(42.31±15.42)岁。B组患者中男30例，女10例，年龄20～70岁，平均年龄(45.93±16.34)岁。两组患者性别、年龄比较差异无统计学意义(P>0.05)，临床可比。
1.2 方法 A组患者确诊谵妄后及时给予氟哌啶醇注射液(徐州莱恩药业有限公司，国药准字H32022182；肌内注射：5～10 mg/次，2～3次/d)治疗；B组患者在确诊谵妄后及时给予盐酸右美托咪定注射液(国药准字H20090248。靜脉微量泵泵入，负荷量为0.5 μ/kg，输注时间10 min；维持剂量在0.3～0.5 μg/(kg·h)治疗，所有受试对象生命体征平稳，意识达到嗜睡状态为治疗目标。, http://www.100md.com(陶晶 王鑫 黄擘)