右美托咪定及咪达唑仑分别应用于AECOPD伴呼吸衰竭治疗的效果观察(1)
摘 要：目的 观察右美托咪定及咪达唑仑在慢性阻塞性肺疾病急性加重期(AECOPD)伴呼吸衰竭患者机械通气治疗过程中镇静效果。方法 选择在我院进行治疗的92例AECOPD伴呼吸衰竭患者作为研究对象，按照随机数字表法分为实验组和对照组，每组46例。实验组给予盐酸右美托咪定注射液治疗，对照组给予咪达唑仑注射液治疗。观察两组患者的镇静效果和镇静情况(停药后清醒时间、机械通气时间、ICU住院时间)。结果 实验组患者停药后清醒时间、机械通气时间和ICU住院时间均短于对照组，镇静有效率高于对照组，差异均有统计学意义(P<0.05)。结论 右美托咪定在AECOPD伴呼吸衰竭患者机械通气治疗过程中镇静效果好，有利于促进患者病情转归、改善预后。
关键词：右美托咪定；咪达唑仑；慢性阻塞性肺疾病加重期；呼吸衰竭；镇静治疗
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.042
, 百拇医药
文章编号：1006-1959(2018)22-0145-02
Efficacy of Dexmetomidine and Midazolam in the Treatment of AECOPD with
Respiratory Failure
QIU Xian-peng
(ICU，the Fourth People's Hospital of Zigong，Zigong 643000，Sichuan，China)
Abstract：Objective To observe the sedative effect of dexmetomidine and midazolam on mechanical ventilation in (AECOPD) patients with respiratory failure in acute exacerbation of chronic obstructive pulmonary disease.Methods 92 AECOPD patients with respiratory failure were selected as the study subjects.According to the random digital table method，patients were divided into experimental group and control group with 46 cases in each group.The experimental group was treated with dexmetomidine hydrochloride and the control group with midazolam injection.The sedation effect and sedation were observed in the two groups (waking time， mechanical ventilation time and ICU hospitalization time after withdrawal).Results The waking time， the time of mechanical ventilation and the hospitalization time of ICU in the experimental group were shorter than those in the control group， and the sedation effective rate was higher than that in the control group，the difference was statistically significant(P<0.05).Conclusion The sedation effect of dexmetomidine in the treatment of AECOPD patients with respiratory failure is good， which is helpful to promote the prognosis of patients with respiratory failure.
, 百拇医药
Key words：Dexmetomidine；Midazolam；Exacerbation of chronic obstructive pulmonary disease； Respiratory failure；Sedation therapy
慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)是臨床上常见呼吸系统疾病之一，感染、胸腔积液等原因使患者在COPD急性加重期(acute exacerbation of chronic obstructive pulmonary disease，AECOPD)容易发展为呼吸衰竭，具有较高的发病率和死亡率[1]。目前，临床上常通过气管插管机械通气的方式来改善AECOPD患者的通气状态，纠正呼吸衰竭，但是患者对气管内插管易发生不耐受、人机抵抗或者过度紧张、焦虑等情绪，从而引起强烈应激反应，增加氧耗，严重者甚至危及生命。因此在患者机械通气过程中选择有效的镇静药物有利于减轻患者不良情绪，减少机械通气时间。右美托咪定为α2-肾上腺素受体激动剂[2]，具有镇静、镇痛、抗焦虑等作用。咪达唑仑为苯二氮卓类药物，具有镇静、催眠、抗焦虑和肌肉松弛等作用。本研究旨在对比右美托咪定或咪达唑仑在AECOPD伴呼吸衰竭患者治疗中的临床效果，现报告如下。
1 资料与方法, 百拇医药(邱显鹏)
关键词：右美托咪定；咪达唑仑；慢性阻塞性肺疾病加重期；呼吸衰竭；镇静治疗
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.22.042
, 百拇医药
文章编号：1006-1959(2018)22-0145-02
Efficacy of Dexmetomidine and Midazolam in the Treatment of AECOPD with
Respiratory Failure
QIU Xian-peng
(ICU，the Fourth People's Hospital of Zigong，Zigong 643000，Sichuan，China)
Abstract：Objective To observe the sedative effect of dexmetomidine and midazolam on mechanical ventilation in (AECOPD) patients with respiratory failure in acute exacerbation of chronic obstructive pulmonary disease.Methods 92 AECOPD patients with respiratory failure were selected as the study subjects.According to the random digital table method，patients were divided into experimental group and control group with 46 cases in each group.The experimental group was treated with dexmetomidine hydrochloride and the control group with midazolam injection.The sedation effect and sedation were observed in the two groups (waking time， mechanical ventilation time and ICU hospitalization time after withdrawal).Results The waking time， the time of mechanical ventilation and the hospitalization time of ICU in the experimental group were shorter than those in the control group， and the sedation effective rate was higher than that in the control group，the difference was statistically significant(P<0.05).Conclusion The sedation effect of dexmetomidine in the treatment of AECOPD patients with respiratory failure is good， which is helpful to promote the prognosis of patients with respiratory failure.
, 百拇医药
Key words：Dexmetomidine；Midazolam；Exacerbation of chronic obstructive pulmonary disease； Respiratory failure；Sedation therapy
慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)是臨床上常见呼吸系统疾病之一，感染、胸腔积液等原因使患者在COPD急性加重期(acute exacerbation of chronic obstructive pulmonary disease，AECOPD)容易发展为呼吸衰竭，具有较高的发病率和死亡率[1]。目前，临床上常通过气管插管机械通气的方式来改善AECOPD患者的通气状态，纠正呼吸衰竭，但是患者对气管内插管易发生不耐受、人机抵抗或者过度紧张、焦虑等情绪，从而引起强烈应激反应，增加氧耗，严重者甚至危及生命。因此在患者机械通气过程中选择有效的镇静药物有利于减轻患者不良情绪，减少机械通气时间。右美托咪定为α2-肾上腺素受体激动剂[2]，具有镇静、镇痛、抗焦虑等作用。咪达唑仑为苯二氮卓类药物，具有镇静、催眠、抗焦虑和肌肉松弛等作用。本研究旨在对比右美托咪定或咪达唑仑在AECOPD伴呼吸衰竭患者治疗中的临床效果，现报告如下。
1 资料与方法, 百拇医药(邱显鹏)