右美托咪啶与咪达唑仑在重症破伤风患者镇静中效果比较

目的:比较右美托咪啶与咪达唑仑用于重症破伤风患者镇静中效果。方法:选取2012年1月~2015年12月间在我院治疗的重症破伤风患者72例,通过随机数表法分为右美托咪啶组与咪达唑仑组,各36例,给予右美托咪啶组静脉泵入右美托咪啶1μg/kg持续时间为10 min,之后以0.3~0.6μg/kg进行维持,咪达唑仑组静脉泵入咪达唑仑0.05 mg/kg,持续时间为1 min,之后以0.02~0.1/kg·h进行维持。监测两组患者用药前及用药12 h后平均动脉压(MAP)、呼吸频率(RR)、血氧饱和度(SpO_2)和心率(HR)深用Ramasy评分法评估镇静程度。结果:两组患者治疗后HR、RR、MAP水平明显降低而SpO_2明显上升且右美托咪啶组HR、RR、及SpO_2改善更显著差异均有统计学意义(P0.05);两组用药后4 h、8 h、12 h时Ramasy评分在组间、组内比较差异均无统计学意义(P0.05);右美托咪啶组不良反应发生率为5.56%,低于咪达唑仑组的16.67%,差异有统计学意义(P0.05)。结论右美托咪啶有助于维持患者血流动力学的稳定减少重症破伤风患者心动过速、心率增快、呼吸抑制等不良反应情况的发生。

Comparison of Dexmedetomidine and Midazolamfor Sedation Effect inPatients with Severe Tetanus

Objective:To compare the Dexmedetomidine and Midazolam for sedation effect in patients with severe tetanus.Methods:Selected 72 patients with severe tetanus treated in our hospital from January 2012 to December 2015, who were divided intoDexmedetomidine group and Midazolam group, with 36 cases in each group through random number table method. Given theDexmedetomidine group intravenous infusion Dexmedetomidine 1 ug/kg, duration 10 min and then keep in 0.3~0.6 ug/kg, and theMidazolam group given intravenous infusion of Midazolam 0.05 mg/kg, duration 1 min, then to 0.02~0.1 ug/kg be maintained. Meanarterial pressure(MAP), respiratory rate (RR), oxygen saturation(SpO2) and heart rate(HR)in two groups before and 12 h after treatmentwere monitored; Ramasy grading method is used to evaluate sedation degree.Results:HR, RR, MAP were significantly decrease, whilethe SpO2 were significantly increased in two groups after treatment (P<0.05), and the SpO2, HR, RR in Dexmedetomidine group aftertreatment improved more than Midazolamgroup, the differences were statistically significant(P<0.05). Ramasy score within and betweentwo groups 4 h, 8 h,12 h after treatment had no statistically significant difference (P>0.05). The incidence of adverse reactions inDexmedetomidine groupwas was 5.56%, which was less than 16.67% in Midazolam group, the difference was statistically significant(P<0.05).Conclusion:Dexmedetomidine helps maintain hemodynamic stability, reducing the incidence of adverse reactions such astachycardia, increased heart rate, respiratory depression and others in patients with severe tetanus.