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目的:观察中药自拟方联合咪达唑仑对重症监护室机械通气患者的镇静效果及安全性。方法:选取140例重症监护室机械通气患者,采取信封法随机分为观察组和对照组各70例,均给予咪达唑仑注射液持续泵入,观察组联合使用中药自拟方。采用Ramsay评分标准对2组的镇静效果进行评分,观察2组的镇静效果。同时对用药前后呼吸动力学指标进行比较。详细记录2组患者的咪达唑仑用量、达到理想镇静所需的时间、停药后苏醒时间以及用药期间出现的不良反应情况。结果:用药后,观察组镇静效果优于对照组(P<0.05),咪达唑仑用量低于对照组(P<0.05),达到理想镇静所需时间及停药后苏醒时间均短于对照组(P<0.05,P<0.01),各呼吸动力学指标值及血压下降、恶心、谵妄等不良反应的发生率均低于对照组(P<0.05,P<0.01)。结论:中药自拟方可起到联合镇静的作用,同时可减轻咪达唑仑带来的副作用。
OBJECTIVE: To observe the sedation effect and safety of self-made Chinese herbs combined with midazolam in intensive care unit patients with mechanical ventilation. Methods: 140 patients with intensive care unit were enrolled in this study. Envelope method was randomly divided into observation group (70 cases) and control group (70 cases). All patients were given midazolam injection continuously and the observation group combined with traditional Chinese medicine. The Ramsay score was used to evaluate the sedation of the two groups and the sedation of the two groups was observed. At the same time before and after treatment of respiratory kinetic parameters were compared. A detailed record of the amount of midazolam in both groups of patients, to achieve the desired time of sedation, withdrawal time after withdrawal and adverse reactions during treatment. Results: After treatment, the sedation of the observation group was better than that of the control group (P <0.05), the dosage of midazolam was lower than that of the control group (P <0.05), the time required for ideal sedation and the recovery time were shorter (P <0.05, P <0.01). The indexes of respiratory dynamics and the incidence of nausea, delirium and other adverse reactions were lower than those of the control group (P <0.05, P <0.01). Conclusion: Chinese medicine self-prepared side can play a combined sedation, while reducing the side effects of midazolam.