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目的:观察小剂量咪达唑仑联合芬太尼对ICU气管插管机械通气患者的镇痛镇静效果。方法:选择2013年7月~2014年11月我院1CU住院的患者48例为研究对象,随机分为观察组25例和对照组23例,观察组静脉注射咪达唑仑0.1~0.2 mg/kg镇静诱导插管成功后,微量注射泵持续静脉注射咪达唑仑和芬太尼;对照组静脉注射咪达唑仑0.1~0.2 mg/kg镇静诱导,插管成功后,未联合应用芬太尼。评价两组患者疼痛、躁动、意外拔管、人机对抗的发生例数。结果:观察组比对照组发生疼痛、躁动、意外拔管、人机对抗的例数较少(P<0.05),差异有统计学意义;两组患者镇静评分无显著差异(P>0.05);观察组较对照组机械通气时间短,差异有统计学意义(P<0.05)。结论:咪达唑仑联合芬太尼静脉泵入可增加机械通气患者的舒适度,减少患者疼痛、躁动、意外拔管、人机对抗的发生例数,缩短机械通气的天数,有利于疾病的早日康复。
Objective: To observe the analgesic and sedative effects of low dose midazolam combined with fentanyl on patients with ICU tracheal intubation mechanical ventilation. Methods: From July 2013 to November 2014, 48 patients hospitalized with 1CU in our hospital were selected and randomly divided into observation group (n = 25) and control group (n = 23). The observation group received intravenous midazolam 0.1 ~ 0.2 mg / kg after intravenous injection of midazolam midazolam 0.1 ~ 0.2 mg / kg sedation induction, the success of intubation, the combination of fentanyl Nepal. Evaluation of two groups of patients with pain, restlessness, accidental extubation, the number of cases of human-computer confrontation. Results: There were fewer cases of pain, agitation, accidental extubation and man-machine confrontation in the observation group than in the control group (P <0.05), and the difference was statistically significant. There was no significant difference between the two groups in sedation scores (P> 0.05). The observation group than the control group, the duration of mechanical ventilation was shorter, the difference was statistically significant (P <0.05). CONCLUSIONS: Midazolam and fentanyl intravenous infusion can increase the comfort of patients with mechanical ventilation and reduce the number of cases of pain, agitation, accidental extubation and man-machine confrontation, shorten the days of mechanical ventilation, get well soon.