摘要
目的探究不同镇痛、镇静方法用于重症监护室抢救性气管插管的有效性及安全性。方法选取2014年7月~2016年7月在本院接收治疗的60例行抢救性气管插管的危重患者,随机分配为观察组和对照组两组形式,每组30例。对照组行抢救性气管插管的危重患者给予咪达唑仑+舒芬太尼,观察组给予丙泊酚+舒芬太尼。对两组患者插管前、插管中其插管后的心率、舒张压(DBP)、收缩压(SBP)、Ramsay评分情况及血氧饱和度(SpO_2),以及心率-收缩压乘积(RPP)进行观察。结果相较于插管前,两组患者在插管中及插管后的RPP、心率、血压明显较低(P<0.05);两组患者对比,SpO_2和Ramsay评分、血流动力学指标(SBP、DBP、HR、RPP)均差异无统计学意义;插管后两组患者的SpO_2均显著高于插管前,插管时两组患者的SpO_2均显著低于插管前(P<0.05);插管时和插管后两组Ramsay评分均显著高于插管前(P<0.05)。结论小剂量咪达唑仑或小剂量丙泊酚复合舒芬太尼,可减轻患者心血管反应,用于危重患者的紧急插管疗效相近,可减少心肌耗氧及患者的痛苦,两组对血流动力学的影响很小,且两者作用相当,具有临床应用价值。
Objective To investigate the efficacy and safety of different methods of analgesia and sedation for emergency endotracheal intubation in intensive care unit （ICU）. Methods From July 2014 to July 2016, 60 patients with severe emergency endotracheal intubation were randomly divided into observation group and control group, 30 patients in each group. The control group was given midazolam ＋ sufentanil and the observation group was given propofol ＋ sufentanil. The heart rate, diastolic blood pressure （DBP）, systolic blood pressure （SBP）, Ramsay score, SpO2, and heart rate - systolic blood pressure product （rpp） were measured before and after intubation. Results Compared with before intubation, the rpp, heart rate and blood pressure in the two groups were significantly lower （P〈0.05）. There was no significant difference in SpO2 and Ramsay scores and hemodynamic indexes （SBP, DBP, HR, rpp） between the two groups. After intubation, SpO2 in both groups was significantly higher than before intubation, while SpO2 in both groups was significantly lower than before intubation （P〈0.05）. Ramsay scores were significantly higher in both groups at intu- bation and after intubation （P〈0.05）. Conclusion Low dose midazolam or low dose propofol combined with sufentanil can reduce the cardiovascular response of patients, emergency intubation in critically ill patients with similar efficacy, can reduce myocardial oxygen consumption and patients＇ pain, the two groups have little effect on hemodynamics, and both have the same effect, has clinical application value.
出处
《当代医学》
2018年第7期40-42,共3页
Contemporary Medicine
关键词
气管插管
镇痛
镇静
重症监护室
Trachea cannula
Analgesia
Calm down
Intensive care unit
