| 邵丽娜,白静慧.右美托咪定在机械通气的恶性肿瘤患者中的应用[J].肿瘤学杂志,2014,20(7):578-581. |
| 右美托咪定在机械通气的恶性肿瘤患者中的应用 |
| Application of Dexmedetomidine for Malignant Tumor Patients Treated with Mechanical Ventilation |
| 投稿时间：2014-01-09 |
| DOI：10.11735/j.issn.1671-170X.2014.07.B011 |
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| 中文关键词: 右美托咪定 咪达唑仑 肿瘤 镇静 镇痛 机械通气 |
| 英文关键词:dexmedetomidine midazolam neoplasms sedation analgesia mechanical ventilation |
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| 中文摘要: |
| 摘 要：［目的］ 观察右美托咪定联合咪达唑仑在恶性肿瘤术后发生呼吸衰竭患者机械通气中的镇静镇痛效果，评价其临床应用的有效性及安全性。［方法］ 因恶性肿瘤术后发生肺内感染导致呼吸衰竭需进行机械通气入住ICU的患者42例，随机分为观察组和对照组，每组各21例。对照组患者应用咪达唑仑镇静，观察组患者应用右美托咪定联合咪达唑仑镇静。比较两组患者镇静效果、疼痛情况、咪达唑仑用量、恢复清醒时间、心率、血压、呼吸频率的变化。［结果］ 右美托咪定联合咪达唑仑能达到满意的镇静效果，镇静满意度82.5%，与对照组相比无显著性差异(P=0.33)；观察组患者咪达唑仑用量明显少于对照组（P＜0.001），VAS评分低于对照组（P＜0.001），且恢复清醒时间亦较对照组短（P＜0.001），差异有统计学意义。［结论］ 对于恶性肿瘤术后发生呼吸衰竭需机械通气的患者，给予右美托咪定联合咪达唑仑的用药方案能达到满意的镇静作用，减少咪达唑仑用量，并有一定的镇痛效果，停用镇静后容易苏醒，降低机械通气时间，值得临床推广。 |
| 英文摘要: |
| Abstract：［Purpose］ To evaluate the sedative and analgesic effects and safety of dexmedetomidine combined with midazolam for post-operative malignant tumor patients undergoing mechanical ventilation．［Methods］ Forty-two malignant tumor patients who occurred respiratory failure because of postoperative pneumonia were admitted to the intensive care unit(ICU) to receive mechanical ventilation，and these patients were randomly divided into experiment group(dexmedetomidine group) and control group(midazolam group)，each group had 21 cases．The control group was treated with midazolam，and the experiment group was treated with dexmedetomidine and midazolam．The sedative effects，pain conditions，dosage of midazolam，awaking time，heart rate，blood pressure and respiratory rate in the two groups were compared. ［Results］ The protocol of dexmedetomidine combined with midazolam achieved satisfactory sedative effects（satisfactory rate of sedation was 82.5%），and there was no significant difference compared with that in control group(P=0.33).The dosage of midazolam and visual simulation (VAS) score in experiment group were lower than those in control group（P＜0.001），and the awaking time in experiment group was shorter than that in control group（P＜0.001），and the differences between two groups were statistically significant. ［Conclusion］ For post-operative malignant tumor patients needing mechanical ventilation，dexmedetomidine can improve the clinical effect of midazolam，shorten midazolam’s dosage，achieve satisfactory sedative and analgesic effects. |
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