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右美托咪定与丙泊酚用于重症监护病房子痫患者镇静的效果比较 被引量:5

Comparison of dexmedetomidine and propofol for sedation of eclampsia patients in intensive care unit
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摘要 目的比较右美托咪定与丙泊酚对子痫患者镇静的临床效果和安全性。方法收集哈尔滨医科大学附属第二医院重症医学科2010年5月-2011年4月在全身麻醉下行剖宫产术且术后需行机械通气的子痫患者40例,按随机数字表法将患者分为右美托咪定组(D组,20例)和丙泊酚组(P组,20例)。D组:给予右美托咪定负荷量1μg.kg-1.h-1经静脉泵注射20 min,根据不同镇静程度持续经静脉泵注射右美托咪定0.3~0.7μg.kg-1.h-1。P组:首先静脉注射1 mg/kg丙泊酚进行镇静诱导,亦根据不同镇静程度维持丙泊酚剂量为0.5~4.0 mg.kg-1.h-1。比较两组患者的心率、血压、降压药物使用情况、芬太尼用量、住重症监护病房(ICU)时间等。结果与P组相比,D组在术后0~24 h的心率显著减慢(P值均〈0.05),而在术后24~72 h的心率的差异均无统计学意义(P值均〉0.05)。与P组相比,D组的降压药物使用率显著降低(P〈0.05),芬太尼使用量显著减少(P〈0.05),住ICU时间显著缩短(P〉0.05)。结论右美托咪定应用于子痫患者镇静安全、有效,能减少降压药物及芬太尼的用量,并能缩短住ICU时间。 Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol for sedation of eclampsia patients.Methods Forty eclampsia patients were admitted to our intensive care unit(ICU) from May 2010 to April 2011.Pregnancies of the patients were terminated via caesarean delivery under general anesthesia and ventilatory support was needed;they were randomly divided into two groups to receive either dexmedetomidine or propofol.The dexmedetomidine group(Group D,n=20) received a loading dose of 1 μg·kg-1·h-1 for 20 min,followed by continuous infusion at 0.3-0.7 μg·kg-1·h-1.The propofol group(Group P,n=20) received a loading dose of 1 mg/kg,followed by continuous infusion at 0.5-4.0 mg·kg-1·h-1.The heart rate,blood pressure,anti-hypertension drug dosage,fentanyl dosage and duration in ICU were compared between the 2 groups.Results Compared with Group P,the heart rate in Group D was significantly slower within 24h after operation(P0.05),and the heart rates were similar between the 2 groups during 24-72 h after operation(P0.05).Moreover,the demand for antihypertensive medicine,the demand for fentanyl,and duration of ICU stay were significantly less in Group D compared with those in Group P(P0.05).Conclusion Dexmedetomidine is safe and effective for the sedation of eclampsia patients,which can reduce the demand for antihypertensive medicine and fentanyl,and shorten the duration of ICU stay.
作者 王洪亮 刘海涛 于凯江 WANG Hongliang,LIU Haitao,YU Kaijiang.Department of Intensive Care Unit,Second Affiliated Hospital of Harbin Medical University,Harbin 150086,Heilongjiang,China
出处 《上海医学》 CAS CSCD 北大核心 2011年第8期613-615,共3页 Shanghai Medical Journal
关键词 右美托咪定 丙泊酚 子痫 重症医学科 Dexmedetomidine Propofol Eclampsia Intensive care unit
作者简介 通信作者:于凯江,电子邮箱为drkaijiang.@sohu.com
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参考文献16

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