小剂量咪达唑仑联合丙泊酚在ICU机械通气患者镇静治疗中的应用效果

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摘要目的探讨小剂量咪达唑仑联合丙泊酚在ICU机械通气患者镇静治疗中的应用效果。方法选取2013年12月～2016年1月本院ICU收治的61例机械通气患者作为研究对象，随机分为A组、B组、C组。A组给予咪达唑仑，B组给予丙泊酚，C组给予小剂量咪达唑仑联合丙泊酚。比较三组的镇静效果、镇静前后生命体征变化、谵妄发生次数。结果C组达到理想镇静目标所需时间显著短于A组和B组，达到RASS评分-2～+1分的次数所占百分比显著高于A组和B组，差异有统计学意义（P＜0.05）。三组镇静前后的RR、HR、SpO2、MAP水平比较，差异有统计学意义（P＜0.05）。三组镇静前后的PaCO2水平比较，差异无统计学意义（P＞0.05）。C组的谵妄阳性次数显著低于A组和B组，差异有统计学意义（P＜0.05）。结论小剂量咪达唑仑联合丙泊酚在ICU机械通气患者中的镇静治疗效果及安全性优于咪达唑仑或丙泊酚单药镇静治疗，值得临床推广应用。

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关键词 ：重症监护室, 机械通气, 镇静, 咪达唑仑, 丙泊酚

Abstract：Objective To investigate the application effect of small dosemidazolam and propofol in sedation treatment of patients undergoingmechanical ventilation in ICU.Methods 61 patients undergoingmechanical ventilation in ICU of our hospital from December 2013 to January 2016 were selected and randomly divided into group A，group B and group C.Group A was given midazolam，group B was given propofol，group C was given small dose midazolam and propofol. Sedative effect，the change of vital signs before and after sedation，occurrence of delirium among three groups was compared respectively.Results The time of achieving ideal sedation in group C was shorter than that in group A and group B，the percentage of the RASSscore reached-2-+1 points in group Cwas higher than that in group A and group B，with significant difference（P＜0.05）.There was significant difference in the level of RR，HR，SpO2，MAP before and after sedation among three groups（P＜0.05）.There was no significant difference in the level of PaCO2before and after sedation among three groups（P＞0.05）.The number of positive delirium in group C was lower than that in group A and group B，with significant difference　（P＜0.05）.Conclusion The effect and safety of small dosemidazolam combined with propofol in ICU mechanical ventilation patients are superior to midazolam or propofol alone，it is worthy of clinical promotion and application.

Key words： Intensive care unit Mechanical ventilation Sedation Midazolam Propofol

引用本文:

张鹏　；魏鹏. 小剂量咪达唑仑联合丙泊酚在ICU机械通气患者镇静治疗中的应用效果[J]. 中国当代医药, 2016, 23(20): 126-128.
ZHANG Peng ；WEIPeng. Application effect of small dose m idazolam and propofol in sedation treatment of patients undergoingmechanical ventilation in ICU. 中国当代医药, 2016, 23(20): 126-128.

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