摘要
目的探讨瑞芬太尼复合丙泊酚对重症监护室(ICU)危重症患者镇静镇痛、应激反应及血流动力学的影响。方法选取2022年6月-2023年6月云阳县人民医院ICU收治的危重症患者98例为研究对象,以随机数字表法分为观察组(n=49)、对照组(n=49)。对照组以丙泊酚镇静治疗,观察组采取瑞芬太尼复合丙泊酚镇静治疗。评估对比两组的镇痛镇静效果、治疗时间、应激反应指标、血流动力学指标、不良反应发生率。结果镇静治疗后观察组视觉模拟评分法(VAS)、Ricker镇静-躁动评估量表(SAS)评分均低于对照组(P<0.05)。观察组机械通气时间、镇静治疗时间、ICU停留时间、住院时间均短于对照组(P<0.05)。治疗后观察组应激反应指标,包括促肾上腺皮质激素(ACTH)、活性氧(ROS)、儿茶酚-O-甲基转移酶(COMT)水平低于对照组(P<0.05)。重复测量方差分析显示,血流动力学指标组间差异、组内差异及组间与组内的交互作用,均有显著差异(P<0.05)。两两精细比较显示,观察组患者在镇静12h(T1)、镇静24h(T2)、镇静48h(T3)时的收缩压(SBP)、舒张压(DBP)、心率(HR)低于对照组,血氧饱和度(SpO2)高于对照组(P<0.05)。两组不良反应发生率分别为12.24%(6/49)、8.16%(4/49),差异不显著(P>0.05)。结论瑞芬太尼复合丙泊酚对ICU危重症患者治疗效果明显,可提高患者的镇痛镇静效果,降低应激反应,改善患者血流动力学,缩短患者治疗时间,治疗安全性良好。
Objective To investigate the effects of remifentanil combine with propofol on sedation and analgesia,stress response and hemodynamics in intensive care unit(ICU)critically ill patients.Methods 98 critically ill patients who were admitted to ICU of Yunyang County People's Hospital from June 2022 to June 2023 were selected as research objects,patients were divided into observation group(n=49)and control group(n=49)by random number table method.Control group was treated with propofol sedation,and observation group was treated with remifentanil combine with propofol sedation.The analgesic and sedative effects,treatment duration,stress response indexes,hemodynamic indexes and incidence of adverse reactions were evaluated and compared in two groups.Results The scores of visual analogue scale(VAS)and Ricker sedation-agitation scale(SAS)in observation group were lower than those in control group after sedation treatment(P<0.05).The mechanical ventilation time,sedation treatment time,ICU stay time and hospitalization time in observation group were shorter than those in control group(P<0.05).The levels of stress response indexes including adrenocorticotropic hormone(ACTH),reactive oxygen species(ROS)and catechol-O-methyltransferase(COMT)in observation group were lower than those in control group after treatment(P<0.05).Repeated measures analysis of variance showed that there were significant differences in hemodynamic parameters between groups,within groups,and interactions between groups and within groups(P<0.05).Pairwise comparison showed that the systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in observation group were lower than those in control group at 12h(T1),24h(T2)and 48h(T3),and the oxygen saturation(SpO2)was higher than that in control group(P<0.05).The incidence of adverse reactions in two groups was 12.24%(6/49)and 8.16%(4/49)(P>0.05).Conclusion Remifentanil combine with propofol has obvious therapeutic effect on ICU critically ill patients,which can improve the analgesic and sedative effect of patients,reduce stress response,improve hemodynamics,shorten the treatment time of patients,and have good treatment safety.
作者
徐树
董敏
何宽
Xu Shu;Dong Min;He Kuan(Yunyang County People's Hospital,Chongqing 404599,China)
出处
《首都食品与医药》
2024年第8期65-68,共4页
Capital Food Medicine
作者简介
通信作者:董敏,邮箱:18723598123@163.com。
