咪唑安定联合瑞芬太尼的400例镇静镇痛效果临床观察(1)
【摘要】 目的 探讨实施咪唑安定联合瑞芬太尼的镇静镇痛效果。方法 800例ICU机械通气患者， 随机分为对照组和观察组， 每组400例。对照组采用异丙芬联合瑞芬太尼镇静镇痛治疗， 观察组采用咪唑安定联合瑞芬太尼镇静镇痛治疗。比较两组患者镇静镇痛效果和生命体征情况。结果 对照组患者视觉模拟评分法(VAS)评分为(7.25±1.45)分明显高于观察组的(3.15±1.25)分， 差异有统计学意义(P<0.05)；对照组患者Ⅱ级和Ⅲ级镇静效果明显低于观察组， 差异有统计学意义(P<0.05)；对照组脉搏输出量明显高于观察组， 收缩压明显低于观察组， 差异有统计学意义(P<0.05)。结论 咪唑安定联合瑞芬太尼具有较好的镇静镇痛作用， 且安全性较高， 值得临床推广使用。
【关键词】 咪唑安定；瑞芬太尼；镇静镇痛
DOI：10.14163/j.cnki.11-5547/r.2017.16.010
Clinical observation of sedation and analgesic effect of midazolam combined with remifentanil in 400 cases ZHU Xue-wu. Fengjie County People’s Hospital， Chongqing 404600， China
【Abstract】 Objective To explore the sedation and analgesic effect of midazolam combined with remifentanil. Methods A total of 800 ICU mechanical ventilation patients were randomly divided into control group and observation group， with 400 cases in each group. The control group received propoful combined with remifentanil for sedation and analgesic treatment， and the observation group received midazolam combined with remifentanil for sedation and analgesic treatment. Comparison were made on sedation and analgesic effect and vital signs situation in two groups. Results The control group had obviously higher visual analogue scale (VAS) score as (7.25±1.45) points than (3.15±1.25) points in the observation group， and the difference had statistical significance (P<0.05). The control group had obviously lower sedative effect in grade Ⅱ and Ⅲ than the observation group， and their difference had statistical significance (P<0.05). The control group had obviously higher pulse output than the observation group， and obviously lower systolic blood pressure than the observation group. Their difference had statistical significance (P<0.05). Conclusion Combination of midazolam and remifentanil shows good sedation and analgesic effect with high safety， and it is worthy of clinical promotion and use.
【Key words】 Midazolam； Remifentanil； Analgesic sedation
ICU患者病情較重， 特别是应用机械通气患者， 由于气管插管给患者带来约束和不适， 使得患者常伴有恐惧、躁动以及焦虑等不良应激反应[1]。镇痛、镇静药可以有效缓解患者恐惧、焦虑、躁动情绪， 减轻患者的应激反应， 提高患者对机械通气的耐受力及抢救成功率[2]。临床上镇静镇痛药物多种多样， 临床效果不一， 不合理的使用， 甚至会对患者血液动力学、呼吸功能等产生不利的影响， 故选择安全、可靠的镇静镇痛药物显得尤为重要[3， 4]。本研究探讨咪唑安定联合瑞芬太尼在ICU患者中的镇静镇痛效果。报告如下。
1 资料与方法
1. 1 一般资料 选取本院2012年10月～2016年10月期间收治的800例ICU机械通气患者， 随机分为对照组和观察组， 每组400例。观察组中男222例， 女178例；年龄18～58岁， 平均年龄(30.25±9.26)岁；体重50～78 kg， 平均体重(60.22±5.93)kg。对照组中男219例， 女181例；年龄19～59岁， 平均年龄(30.24±9.59)岁；体重49～79 kg， 平均体重(60.15±6.29)kg。两组患者一般资料比较， 差异无统计学意义(P>0.05)， 具有可比性。, 百拇医药(朱学武)
【关键词】 咪唑安定；瑞芬太尼；镇静镇痛
DOI：10.14163/j.cnki.11-5547/r.2017.16.010
Clinical observation of sedation and analgesic effect of midazolam combined with remifentanil in 400 cases ZHU Xue-wu. Fengjie County People’s Hospital， Chongqing 404600， China
【Abstract】 Objective To explore the sedation and analgesic effect of midazolam combined with remifentanil. Methods A total of 800 ICU mechanical ventilation patients were randomly divided into control group and observation group， with 400 cases in each group. The control group received propoful combined with remifentanil for sedation and analgesic treatment， and the observation group received midazolam combined with remifentanil for sedation and analgesic treatment. Comparison were made on sedation and analgesic effect and vital signs situation in two groups. Results The control group had obviously higher visual analogue scale (VAS) score as (7.25±1.45) points than (3.15±1.25) points in the observation group， and the difference had statistical significance (P<0.05). The control group had obviously lower sedative effect in grade Ⅱ and Ⅲ than the observation group， and their difference had statistical significance (P<0.05). The control group had obviously higher pulse output than the observation group， and obviously lower systolic blood pressure than the observation group. Their difference had statistical significance (P<0.05). Conclusion Combination of midazolam and remifentanil shows good sedation and analgesic effect with high safety， and it is worthy of clinical promotion and use.
【Key words】 Midazolam； Remifentanil； Analgesic sedation
ICU患者病情較重， 特别是应用机械通气患者， 由于气管插管给患者带来约束和不适， 使得患者常伴有恐惧、躁动以及焦虑等不良应激反应[1]。镇痛、镇静药可以有效缓解患者恐惧、焦虑、躁动情绪， 减轻患者的应激反应， 提高患者对机械通气的耐受力及抢救成功率[2]。临床上镇静镇痛药物多种多样， 临床效果不一， 不合理的使用， 甚至会对患者血液动力学、呼吸功能等产生不利的影响， 故选择安全、可靠的镇静镇痛药物显得尤为重要[3， 4]。本研究探讨咪唑安定联合瑞芬太尼在ICU患者中的镇静镇痛效果。报告如下。
1 资料与方法
1. 1 一般资料 选取本院2012年10月～2016年10月期间收治的800例ICU机械通气患者， 随机分为对照组和观察组， 每组400例。观察组中男222例， 女178例；年龄18～58岁， 平均年龄(30.25±9.26)岁；体重50～78 kg， 平均体重(60.22±5.93)kg。对照组中男219例， 女181例；年龄19～59岁， 平均年龄(30.24±9.59)岁；体重49～79 kg， 平均体重(60.15±6.29)kg。两组患者一般资料比较， 差异无统计学意义(P>0.05)， 具有可比性。, 百拇医药(朱学武)