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目的评价续贯应用咪唑安定和异丙酚对ICU机械通气病人的镇静效果、安全性及其费用。方法选择在ICU需机械通气的病人42例,随机分为咪唑安定组(M组)、异丙酚组(P组)和咪唑安定、异丙酚续贯组(M-P组)3组。M和P组分别应用注射泵持续静注咪唑安定或异丙酚镇静,M-P组先以咪唑安定镇静,在计划停止镇静6h前转为异丙酚。分别观察3组血压、心率、血氧饱和度;停药后苏醒时间;停药后入睡及恶心发生情况;费用等。结果P组用药后5min时的血压明显低于用药前及其他两组(P<0.05),3组镇静治疗前后心率、血氧饱和度的影响均不明显。M-P组、P组苏醒时间、恶心发生率和苏醒后再入睡率无显著性差异,但两组与M组相比,苏醒时间快,且恶心发生率和苏醒后再入睡率明显降低。M-P组与P组相比,费用明显降低。结论续贯使用咪唑安定和异丙酚镇静安全、有效、费用较低。
Objective To evaluate the sedation, safety and cost of intermittent use of midazolam and propofol in ICU patients with mechanical ventilation. Methods Forty-two patients undergoing mechanical ventilation in the ICU were randomly divided into three groups: midazolam group (M group), propofol group (P group), midazolam group and propofol group (M-P group) M and P groups were treated with intravenous infusion of midazolam or propofol sedation, M-P group first sedative with midazolam, propofol was stopped 6h before planned to stop sedation. Blood pressure, heart rate and oxygen saturation were observed in 3 groups respectively; recovery time after withdrawal; sleep onset and nausea after withdrawal; cost and so on. Results The blood pressure at 5 min after P group was significantly lower than that before treatment and the other two groups (P <0.05). The effect of heart rate and blood oxygen saturation was not significant before and after sedation treatment. There was no significant difference in wakefulness, nausea and re-entry rate after awakening in M-P group and P group, but the recovery time was faster in both groups than in M group. M-P group compared with the P group, the cost was significantly reduced. Conclusions Sedation with midazolam and propofol was safe, effective and cost-effective.