右美托咪定、咪达唑仑对重症破伤风患者治疗时的镇静效果

doi:10.3969/j.issn.1671-7171.2022.05.019

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摘要【目的】探讨右美托咪定、咪达唑仑对重症破伤风患者治疗时的镇静效果。【方法】选择2018年9月至2020年9月在宝鸡市人民医院治疗的重症破伤风患者64例作为研究对象,根据患者入院先后顺序分为观察组和对照组,每组32例。观察组给予人破伤风免疫球蛋白联合右美托咪定治疗,对照组给予人破伤风免疫球蛋白联合咪达唑仑治疗。监测两组患者用药前、用药12 h时脉搏血氧饱和度(SpO₂)、心率(HR)、呼吸频率(RR)、平均动脉压(MAP),用Ramsay评分评价患者镇静程度,统计并比较两组患者不良反应发生率、病死率。【结果】用药12 h,两组患者SpO₂均升高(P<0.05),HR、RR、MAP均降低(P<0.05),且观察组患者SpO₂高于对照组(P<0.05),HR、RR、MAP均低于对照组(P<0.05)。用药3 h,两组患者Ramsay评分均较治疗前升高(P<0.05),但两组比较差异无统计学意义(P>0.05)。观察组患者不良反应总发生率为6.25%,低于对照组的25.00%,差异有统计学意义(χ²=4.267,P=0.039)。观察组患者病死率为3.13%(1/32),与对照组的9.38%(3/32)比较,差异无统计学意义(Fisher精确检验,P=0.613)。【结论】针对重症破伤风患者,应用人破伤风免疫球蛋白联合右美托咪定治疗能取得良好的镇静效果,改善患者SpO₂、HR、RR、MAP,且不良反应少。

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	冯毅凡
	刘康

关键词 ：破伤风, 右美托咪啶/药理学, 咪达唑仑/药理学, 清醒镇静

Abstract：【Objective】 To investigate the clinical effect of dexmedetomidine and midazolam on sedation in patients with severe tetanus. 【Methods】 A total of 64 patients with severe tetanus treated in Baoji People's Hospital from September 2018 to September 2020 were selected as the research object. According to the order of admission, they were divided into observation group and treatment group, with 32 cases in each group. The observation group was treated with human tetanus immunoglobulin combined with dexmedetomidine, and the control group was treated with human tetanus immunoglobulin combined with midazolam. The pulse oxygen saturation (SpO₂), heart rate (HR), respiratory rate (RR) and mean arterial pressure (MAP) of the two groups were monitored before and 12 hours after treatment. The degree of sedation was evaluated by Ramsay score. The incidence of adverse reactions and mortality of the two groups were counted and compared. 【Results】 After 12 hours of treatment, SpO₂ increased (P<0.05), HR, RR and MAP decreased (P<0.05), SpO₂ in the observation group was higher than that in the control group (P<0.05), and HR, RR and MAP were lower than those in the control group (P<0.05).After 3 hours of treatment, the Ramsay score of the two groups was higher than that before treatment (P<0.05), but there was no significant difference between the two groups (P>0.05).The incidence of adverse reactions in the observation group was 6.25%, which was significantly lower than that in the observation group was 25.00%.The mortality of patients in the observation group was 3.13% (1/32), and there was no significant difference compared with 9.38% (3/32) in the group B (Fisher exact test,P=0.613). 【Conclusion】 For patients with severe tetanus, the application of human tetanus immunoglobulin combined with dexmedetomidine can achieve good sedative effect, improve SpO₂, HR, RR and MAP, and have less adverse reactions.

Key words： Tetanus Dexmedetomidine/PD Midazolam/PD Conscious Sedation

收稿日期: 2021-12-05

中图分类号:

R517.3

通讯作者: *E-mail: 23417535@qq.com

引用本文:

冯毅凡, 刘康. 右美托咪定、咪达唑仑对重症破伤风患者治疗时的镇静效果[J]. 医学临床研究, 2022, 39(5): 709-712.
FENG Yi-fan, LIU Kang. Clinical Study on Sedative Effect of Dexmedetomidine and Midazolam in Patients with Severe Tetanus. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 709-712.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.05.019 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I5/709