右美托咪定与咪达唑仑在PICU机械通气患儿镇静效果的比较研究

目的 比较分析右美托咪定与咪达唑仑在PICU机械通气患儿镇静的临床效果及不良反应.方法 选取2013年3月至2014年12月入住我院PICU,需行机械通气辅助治疗并需镇静的患儿100例,采用随机数字表分为实验组和对照组.两组患者的一般资料相仿,差异无统计学意义(P＞0.05),实验组予以右美托咪定镇静,对照组予咪达唑仑镇静,采用Ramsay评分标准评估镇静水平,观察两组患儿药物镇静时间,停药后唤醒时间,镇静4h后血压、心率、呼吸抑制情况并记录两组患儿谵妄发生情况及两组患儿PICU时间及机械通气时间,并进行比较分析.结果 ①两组达到镇静时间相比较,差异无统计学意义(P＞0.05),两组停药后苏醒时间及两组患儿镇静评分相比较,实验组优于对照组(P＜0.05);②谵妄及呼吸抑制发生率实验组少于对照组(P＜0.05),低血压及心动过缓两组差异无统计学意义(P＞0.05);③实验组PICU时间(47.5± 10.2)h,机械通气时间(125±12.6)h,对照组PICU时间(80.8±11.9)h,机械通气时间(165±13.8)h,两组相比较,实验组优于对照组,差异具有统计学意义(P ＜0.05).结论 右美托咪定组镇静具有能够减少PICU时间及机械通气时间,减少谵妄及呼吸抑制的发生,并能明显缩短苏醒时间等优势,值得临床推广.

Comparison of dexmedetomidine and midazolam in children with mechanical ventilation in PICU sedation

Objective To compare the clinical effects of sedation between dexmedetomidine and midazolam on children with mechanical ventilation in PICU.Methods We selected 100 children from March 2013 to December 2014 in PICU of our hospital,who required treatment of mechanicalventilation adjuvant therapy and needed to keep sedation,and the children were randomly divided into experimental group and control group.General information on the two groups were similar,the difference was not statistically significant (P ＞0.05).The children of experimental group were received dexmedetomidine to keep sedative and the control group were given midazolam to keep sedation.Adopt criteria for assessing the level of sedation Ramsay score were observed in children with drugs sedation time,wake time after stopping after sedation 4 hours blood pressure,heart rate,respiratory depression and record groups of children and the incidence of delirium PICU time and the two groups of children duration of mechanical ventilation,and compared.Results ① Both groups achieved sedation compared,there was no significant difference between the two groups after the withdrawal and recovery time compared two groups of children sedation scores (P ＞0.05),the difference was statistically significant,the experimental group than the control group (P ＜ 0.05);② The incidence of delirium and respiratory depression in the experimental group than the control group (P ＜ 0.05),there was no hypotension and bradycardia significant difference (P ＞0.05);③The experimental group PICU times were (47.5 ± 10.2) hours,duration of mechanical ventilation times were (125 ±12.6) hours,PICU times of control group were (80.8±11.9) hours,the times of mechanical ventilation were (165±13.8) hours,compared with the two groups,the experimental group were better than the control group (P ＜ 0.05).Conclusions Dexmedetomidine sedative given group can reduce the PICU time and duration of mechanical ventilation,reduce the incidence of delirium and respiratory depression,and can significantly shorten the recovery time and other advantages,whioh is worthy of promotion.