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[目的]观察右美托咪定联合咪达唑仑在恶性肿瘤术后发生呼吸衰竭患者机械通气中的镇静镇痛效果,评价其临床应用的有效性及安全性。[方法]因恶性肿瘤术后发生肺内感染导致呼吸衰竭需进行机械通气入住ICU的患者42例,随机分为观察组和对照组,每组各21例。对照组患者应用咪达唑仑镇静,观察组患者应用右美托咪定联合咪达唑仑镇静。比较两组患者镇静效果、疼痛情况、咪达唑仑用量、恢复清醒时间、心率、血压、呼吸频率的变化。[结果]右美托咪定联合咪达唑仑能达到满意的镇静效果,镇静满意度82.5%,与对照组相比无显著性差异(P=0.33);观察组患者咪达唑仑用量明显少于对照组(P<0.001),VAS评分低于对照组(P<0.001),且恢复清醒时间亦较对照组短(P<0.001),差异有统计学意义。[结论]对于恶性肿瘤术后发生呼吸衰竭需机械通气的患者,给予右美托咪定联合咪达唑仑的用药方案能达到满意的镇静作用,减少咪达唑仑用量,并有一定的镇痛效果,停用镇静后容易苏醒,降低机械通气时间,值得临床推广。
[Objective] To observe the sedation and analgesia effect of dexmedetomidine combined with midazolam in mechanical ventilation in patients with respiratory failure after malignant tumor operation, and to evaluate the clinical efficacy and safety of dexmedetomidine combined with midazolam. [Method] 42 patients with respiratory failure due to pulmonary infection after malignant tumor requiring mechanical ventilation were randomly divided into observation group and control group, with 21 patients in each group. Patients in the control group were treated with midazolam sedation, and patients in the observation group were treated with dexmedetomidine plus midazolam sedation. The sedation, pain, the amount of midazolam, recovery of awake time, heart rate, blood pressure and respiratory rate were compared between the two groups. [Results] Dexmedetomidine combined with midazolam achieved satisfactory sedation effect. The sedation satisfaction was 82.5%, showing no significant difference compared with the control group (P = 0.33). The dosage of midazolam in the observation group was significantly Less than the control group (P <0.001), VAS score was lower than the control group (P <0.001), and the recovery of awake time was also shorter than the control group (P <0.001), the difference was statistically significant. [Conclusion] The treatment regimen of dexmedetomidine combined with midazolam can achieve satisfactory sedation, reduce the dosage of midazolam and have a certain degree of certainty in patients with respiratory failure requiring mechanical ventilation after malignant tumor Pain effect, disable the sedation easy to wake up, reduce the mechanical ventilation time, it is worth clinical promotion.