[1]吴 萌,王 平.右美托咪啶对老年重症肺炎有创机械通气患者镇静效果研究[J].医学信息,2018,31(16):118-119125.[doi:10.3969/j.issn.1006-1959.2018.16.036]
　WU Meng,WANG Ping.Effect of Dexmedetomidine on Sedation in Elderly Patients with Severe Pneumonia Undergoing Invasive Mechanical Ventilation[J].Journal of Medical Information,2018,31(16):118-119125.[doi:10.3969/j.issn.1006-1959.2018.16.036]
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右美托咪啶对老年重症肺炎有创机械通气患者镇静效果研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年16期
页码:
118-119125
栏目:
药物与临床
出版日期:
2018-08-15

文章信息/Info

Title:
Effect of Dexmedetomidine on Sedation in Elderly Patients with Severe Pneumonia Undergoing Invasive Mechanical Ventilation
文章编号:
1006-1959（2018）16-0118-03
作者:
吴 萌; 王 平
成都市第五人民医院重症医学科，四川 成都 611130
Author(s):
WU Meng; WANG Ping
Department of Critical Care Medicine,Chengdu Fifth People's Hospital,Chengdu 611130,Sichuan,China
关键词:
老年重症肺炎; 机械通气; 右美托咪啶; 镇静; 谵妄
Keywords:
Key words：Severe pneumonia in the elderly; Mechanical ventilation; Dexmedetomidine; Sedation; Delirium
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2018.16.036
文献标志码:
A
摘要:
目的 探讨右美托咪啶用于老年重症肺炎有创机械通气患者镇静中的效果及安全性。方法 选取2016年1月~2017年6月需呼吸机辅助呼吸的ICU老年重症肺炎患者40例，通过随机数字表法分为观察组及对照组，每组20例。在常规治疗的基础上，观察组以右美托咪定治疗，对照组以咪达唑仑镇静治疗，观察两组患者达到理想镇静状态所需时间、谵妄发生率、心血管不良事件发生率、ICU驻留时间等指标。结果 观察组达到理想镇静状态所需时间、血压及心率下降率与对照组比较，差异无统计学意义（P＞0.05）；观察组患者谵妄发生率为5.00%及ICU驻留时间为（187.89±15.86）h，均低于对照组15.00%、（235.56±16.42）h，差异有统计学意义（P＜0.05）。结论 与对照组比较，在老年重症肺炎有创机械通气患者中使用右美托咪啶可以有效降低患者谵妄发生率，缩短患者的ICU驻留时间，进一步改善预后。
Abstract:
Abstract：Objective To investigate the efficacy and safety of dexmedetomidine in sedation of elderly patients with severe pneumonia undergoing invasive mechanical ventilation.Methods 40 patients with severe pneumonia in the ICU who needed ventilator-assisted breathing from January 2016 to June 2017 were enrolled.The patients were divided into observation group and control group by random number table,20 cases in each group.On the basis of conventional treatment,the observation group was treated with dexmedetomidine,and the control group was treated with midazolam sedation.The time required for the two groups to achieve ideal sedation,the incidence of sputum, the incidence of cardiovascular adverse events,indicators such as ICU dwell time.Results There was no significant difference in the time,blood pressure and heart rate between the observation group and the control group(P>0.05). The incidence of sputum was 5.00% and the ICU stay time was(187.89±15.86)h was lower than the control group 15.00%,(235.56±16.42)h,the difference was statistically significant(P<0.05).Conclusion Compared with the control group, the use of dexmedetomidine in elderly patients with severe pneumonia invasive mechanical ventilation can effectively reduce the incidence of delirium,shorten the ICU residence time,and further improve the prognosis.

参考文献/References:

[1]龙晓莉,王永红,卢卫琴,等.机械通气联合盐酸氨溴索对老年急性呼吸窘迫综合征患者氧合指标和炎性因子的影响[J].中国老年学杂志,2015,35(01):1-2.
[2]Mandell LA,Wunderink RG,Anzueto A,et al.Infectious Diseases Society of America American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults[J].Clin Infect Dis.2007,44(2):S27.
[3]中华医学会重症医学分会.中国成人ICU镇痛和镇静治疗指南[J].中华重症医学电子杂志:网络版,2018(2):90-113.
[4]沈威.ICU患者谵妄与精神药物使用研究[J].中国继续医学教育,2018,10(07):116-118.
[5]张俭,钟言,黄竞.右美托咪定对超高龄老年患者循环系统的影响[J].中国老年学杂志,2016,(2):398-399.
[6]Pasin L,Greco T,Feltracco P,et al.Dexmedetomidine as a sedative agent in critically ill patients:a meta-analysis of randomized controlled trials[J].Plos One,2013,8(12).
[7]常燕,周玉梅,陈永权.右美托咪定对老年患者术后认知功能障碍影响的进展[J].中外健康文摘,2013,(14):208-208.
[8]Azeem T,Yosif NE,Alansary AM,et al.Dexmedetomidine vs morphine and midazolam in the prevention and treatment of delirium after adult cardiac surgery;a randomized,double-blinded clinical trial[J].Saudi Journal of Anaesthesia,2018,12(2):190-197.

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更新日期/Last Update: 2018-08-15