危雪晖

【摘要】 目的：探討不同剂量地佐辛对ICU机械通气患者镇静效果及血流动力学的影响。方法：选择2018年1月-2021年7月于江西省抚州市第一人民医院行ICU机械通气的105例患者作为研究对象，按照随机数字表法分为低剂量组、高剂量组和研究组，每组35例。低剂量组给予地佐辛1.0 mg/h，研究组给予地佐辛1.5 mg/h，高剂量组给予地佐辛2.0 mg/h。记录并比较各组给药前与给药6、12、24、48 h时的血流动力学相关指标水平、镇静评分（RASS）、机械通气时间和ICU住院时间。结果：给药前后三组收缩压/舒张压（SBP/DBP）、心率（HR）、呼吸频率（RR）、血氧饱和度（SpO2）均无明显改变，水平相对稳定，组间数据比较差异均无统计学意义（P>0.05）;给药后，三组均有一定的镇静效果，且研究组和高剂量组的RASS评分均显著低于低剂量组，差异均有统计学意义（P<0.05）;低剂量组、研究组的机械通气时间和ICU住院时间均明显短于高剂量组，且研究组的机械通气时间和ICU住院时间均短于低剂量组，差异均有统计学意义（P<0.05）。结论：三种不同剂量的地佐辛均能为ICU机械通气患者提供稳定的血流动力学指标水平，效镇静效果相当。采用1.5 mg/h泵入可以缩短患者机械通气时间及ICU住院时间。

【关键词】 地佐辛 机械通气 镇静效果 血流动力学 ICU

Study on the Effects of Different Doses of Dezocine on the Sedative Effect and Hemodynamics of Mechanically Ventilated Patients in ICU/WEI Xuehui. //Medical Innovation of China， 2021， 18（36）： 005-009

[Abstract] Objective： To investigate the effect of different doses of Dezocine on the sedative effect and hemodynamics of mechanically ventilated ICU patients. Method： A total of 105 ICU patients who underwent mechanical ventilation in The First Peoples Hospital of Fuzhou， Jiangxi Province from January 2018 to July 2021 were selected as the subjects， they were divided into low-dose group， high-dose group and study group according to random number table method， 35 patients in each group. The low-dose group was given Dezocine 1.0 mg/h， the study group was given Dezocine 1.5 mg/h， and the high-dose group was given Dezocine 2.0 mg/h. The levels of hemodynamic related indexes， sedation score （RASS）， mechanical ventilation time and ICU hospitalization time before administration and at 6， 12， 24 and 48 hours administration were recorded and compared. Result： The systolic/diastolic blood pressure （SBP/DBP）， heart rate （HR）， respiratory rate （RR） and blood oxygen saturation （SpO2） of the three groups had no significant changes before and after administration， the levels were relatively stable， and the data comparison between the groups were not statistically significant （P>0.05）; after administration， the three groups had certain sedative effect， and the RASS scores of the study group and the high-dose group were significantly lower than those of the low-dose group， the differences were statistically significant （P<0.05）; the mechanical ventilation time and ICU hospitalization time in the low-dose group and the study group were significantly shorter than that of the high-dose group， and the mechanical ventilation time and ICU hospitalization time of the study group were shorter than those of the low-dose group， the differences were statistically significant （P<0.05）. Conclusion： Three different doses of Dezocine can provide stable hemodynamic index levels for mechanically ventilated patients in ICU， and have equivalent sedative effects. The use of 1.5 mg/h pumping can shorten the time of mechanical ventilation and ICU hospitalization.

[Key words] Dezocine Mechanical ventilation Sedative effect Hemodynamics ICU

First-authors address： Fuzhou First Peoples Hospital， Jiangxi Province， Fuzhou 344000， China

doi：10.3969/j.issn.1674-4985.2021.36.002

机械通气为ICU重症呼吸衰竭患者临床支持治疗的手段之一，通过机械装置代替、控制或辅助患者进行自主呼吸运动[1]。但在进行机械通气治疗的过程中，患者很容易出现肺部感染而导致呼吸机相关性肺炎，此外，重症患者大多存在着多种致痛因素，这些不良因素如未得到及时的处理，可能会加重患者的病情[2]。2013年美国ICU成年患者疼痛、躁动和谵妄处理指南（IPAD）指出，合理、适当的镇静镇痛可有效地减少ICU机械通气患者的应激反应，减少焦虑因素，提高治疗效果[3]。目前，因新型阿片类药物地佐辛具有起效快、持续时间久、镇痛效应强等特点，在临床麻醉及术前镇静中已得到广泛应用，但在ICU通气患者镇静中的应用报道却较少见[4]。为了……