| 刘炳信,甘金荣,余 斌,王 强,张 进.右美托咪啶联合咪达唑仑在颅脑创伤中的镇静效果及对神经内分泌的影响[J].,2018,(19):3737-3741 |
| 右美托咪啶联合咪达唑仑在颅脑创伤中的镇静效果及对神经内分泌的影响 |
| Sedative Effect of Dexmedetomidine Combined with Midazolam in Craniocerebral Trauma and its Influence on Neuroendocrine Function |
| 投稿时间：2018-02-28 修订日期：2018-03-23 |
| DOI：10.13241/j.cnki.pmb.2018.19.031 |
| 中文关键词: 颅脑创伤 右美托咪啶 咪达唑仑 镇静效果 神经内分泌 |
| 英文关键词: Craniocerebral trauma Dexmedetomidine Midazolam Sedative effect Neuroendocrine |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪啶联合咪达唑仑在颅脑创伤中的镇静效果及对神经内分泌的影响。方法：选择2015年3月至2016年5月我院收治的82例颅脑外伤患者，随机分为对照组（n=41）和观察组（n=41），对照组患者给予丙泊酚联合右美托咪啶镇静治疗，观察组患者则给予右美托咪啶联合咪达唑仑镇静治疗。比较两组患者24 h内镇静效率、镇静1 d医疗费用及用药前后呼吸循环功能变化、血清皮质醇、β-内啡肽水平、外周血白细胞计数以及血糖水平。结果：观察组镇静1 d医疗费用较对照组降低，有统计学差异（P<0.05），但两组镇静效率比较无统计学差异（P>0.05）。用药后观察组患者平均动脉压（MAP）、心率（HR）和呼吸频率（RR）分别高于对照组，差异具有统计学意义（P<0.05），而血氧饱和度（SpO2）、中心静脉压（CVP）比较无统计学差异（P>0.05）。用药后两组患者血清皮质醇、β-内啡肽均较用药前降低，观察组血清皮质醇、β-内啡肽均高于对照组，差异具有统计学意义（P<0.05）。用药后观察组患者外周血白细胞计数、血糖水平较用药前降低，对照组患者血糖水平较用药前降低，观察组患者外周血白细胞计数显著低于对照组，差异具有统计学意义（P<0.05）。结论：右美托咪啶联合咪达唑仑应用于颅脑创伤中的镇静效果显著，可有效控制颅脑创伤后的过度应激反应，降低神经内分泌系统紊乱，减少医疗费用，值得临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the sedative effect of dexmedetomidine combined with midazolam in craniocerebral trauma and its influence on neuroendocrine function. Methods: 82 patients with craniocerebral trauma treated in our hospital from March 2015 to May 2016 were selected. They were randomly divided into control group (n=41) and observation group (n=41). The control group re- ceived propofol and dexmedetomidine sedation, the observation group received dexmedetomidine combined with midazolam sedation. The sedation efficiency within twenty-four hours, medical expenses within one day sedation were compared between the two groups. The respiratory and circulatory function changes, serum cortisol, β-endorphin levels, peripheral blood leukocyte count and blood glucose levels before and after treatment were compared between the two groups. Results: The medical expenses within one day sedation in the obser- vation group were lower than that in the control group, the difference was statistically significant (P<0.05). There was no statistical differ- ence in the sedation efficiency between the two groups(P>0.05). After treatment, the average arterial pressure (MAP), heart rate (HR) and respiratory rate(RR) of the observation group were significantly higher than those in the control group, the differences were statistically significant(P<0.05). There was no statistical difference in blood oxygen saturation (SpO2), central venous pressure (CVP) between the two groups(P>0.05). After treatment, the serum cortisol, β-endorphin in the two groups were lower than before treatment. The serum cor- tisol, β-endorphin in observation group were higher than that in control group, the differences were statistically significant(P<0.05). After treatment, the peripheral blood leukocyte count and blood glucose in observation group were lower than before treatment. The blood glu- cose in control group was lower than before treatment. The peripheral blood leukocyte count in observation group was lower than that in control group, the differences were statistically significant (P<0.05). Conclusion: Dexmedetomidine combined with midazolam is effec- tive in the treatment of craniocerebral trauma. It can effectively control the excessive stress reaction after craniocerebral trauma, and reduce the neuroendocrine system disorder and medical expenses, which is worthy of clinical application. |
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