镇痛在机械通气患者镇静镇痛治疗中的作用临床分析*(1)
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[摘要] 目的 探讨镇痛在机械通气患者镇静镇痛治疗中的作用。方法 将50例经口气管插管内科疾病患者随机分成咪达唑仑针镇静组与咪达唑仑针镇静基础上同时芬太尼针镇痛组，观察其镇静效果及达到镇静目标值后1h及12h的呼吸与血流动力学的变化，并进行比较。结果 镇静镇痛组在达到镇静目标值后的呼吸与血流动力学改善优于镇静组，两组在1h后心率、血压方面，镇静镇痛组与镇静组比较有显著性差异(P<0.05)，12h后心率指标镇静镇痛组与镇静组比较有显著性差异(P<0.05)。结论 机械通气患者在镇静基础上给予镇痛治疗更加合理。
[关键词] 镇痛；镇静；机械通气；咪达唑仑；芬太尼
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2011)34-34-02
The Efficiency of Analgesia in the Treatment of Sedation and Analgesia for Patients Receiving Mechanical Ventilation: A Clinical Analysis
HUANG Chaozong LIAO Baoyu ZHENG Siguang LIN Xiaoyin
Intesive Care Unit of the Third People's Hospital of Cangnan County of Wenzhou City in Zhejiang Province，Cangnan 325804，China
[Abstract] Objective To evaluate the efficiency of analgesia in the treatment of sedation and analgesia for patients receiving mechanical ventilation. Methods Fifty patients with medical illness undergoing orotracheal intubation were randomly divided into the midazolam sedation group (the sedation group) and the midazolam sedation combined with fentanyl analgesia group (the sedation and analgesia group) with 25 cases in each. Sedative effects and respiratory and hemodynamic changes one hour and 12 hours after reaching target value of sedation in two groups were observed and compared. Results Respiratory and hemodynamic improvement after reaching target value of sedation in sedation and analgesia group was superior to that of sedation group. Significant differences were found in heart rate and blood pressure after one hour(P<0.05) and in heart rate after 12 hours between the sedation and analgesia group and the sedation group(P<0.05). Conclusion It is more reasonable to give analgesia treatment on the basis of sedation to patients receiving mechanical ventilation.
[Key words] Analgesia；Sedation；Mechanical ventilation；Midazolam；Fentanyl
目前的医疗活动中，机械通气是一种常用技术，但机械通气在给人们带来希望的同时也带来了明显的不良影响，如何扬长避短，人们在开展机械通气治疗的过程中，逐渐发现镇静镇痛治疗在机械通气治疗中的必要性。本文总结了2009年4月~2011年3月使用咪达唑仑针镇静的基础上联合芬太尼针镇痛治疗的病例，在机械通气过程中探讨镇痛在机械通气患者镇静治疗中的作用，具体报道如下。
1 资料与方法
1.1 对象
选取我院2009年4月~2011年3月使用机械通气治疗的患者共50例，全部为经口气管插管内科疾病患者 ......
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