首页|右美托咪啶两种联合用药方案对颅脑损伤患者镇静作用及药物经济学比较研究

右美托咪啶两种联合用药方案对颅脑损伤患者镇静作用及药物经济学比较研究

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目的 比较对颅脑损伤患者使用右美托咪啶联用丙泊酚和右美托咪啶联用咪达唑仑两种用药方式的临床疗效以及药物经济学.方法 选取2015年2月~2016年9月于天津医科大学第二医院治疗的94例颅脑损伤患者,随机分为A组与B组,每组47例.A组患者给予右美托咪啶联合丙泊酚药物治疗,B组患者给予右美托咪啶联合咪达唑仑药物治疗,除药物治疗方式外其他用药及护理方式相同,使躁动评分(SAS)维持在2~4的标准状态,观察所有患者的镇静效率、平均动脉压(MAP)、呼吸速率(RR)、心率(HR)、血氧饱和度(SpO2)、动脉二氧化碳分压(PaCO2)、中心静脉压(CVP)和格拉斯哥昏迷程度评分(GCS)的变化,同时比较两种方案的药物经济学.结果 右美托咪啶的两种联合用药方案均能使患者达到预计的镇静镇痛评分,两种用药方式的镇静效率无统计学差异;2组患者治疗前后的血氧饱和度(SpO2)、动脉二氧化碳分压(PaCO2)、中心静脉压(CVP)及格拉斯哥昏迷程度评分(GCS)均无统计学差异(P>0.05),但患者治疗前后的平均动脉压(MAP)、呼吸频率(R)及心率(HR)均有明显下降,差异具有统计学意义(P<0.05);右美托咪啶联用咪达唑仑的用药方案相较于右美托咪啶联合丙泊酚的用药方案更为经济,且差异具有统计学意义(P<0.05).结论 对于颅脑损伤患者使用右美托咪啶联合丙泊酚和右美托咪啶联合咪达唑仑两种用药方案均可取得良好的镇静效果,但丙泊酚联用组相较咪达唑仑联用组对呼吸系统及循环系统有更好的抑制作用,同时在药物经济学角度,咪达唑仑联用组比丙泊酚联用组更为经济,患者承担费用更低.
Comparative analysis of sedative effects and pharmacoeconomic profiles mediated by two kinds of combination of dexmedetomidine in traumatic brain injury patients
Objective To compare the sedative effects and pharmacoeconomic profiles of two kinds of combination of dexmedetomidine in traumatic brain injury patients.Methods94 cases of traumatic brain injury from February 2015 to September 2016 were selected and randomly divided into two groups including A group(47 patients) and B group(47 patients).All patients received the same nursing intervention before and after operation.Patients in group A were given right of dexmedetomidine combined with propofol drug therapy, patients in group B were given dexmedetomidine combined with midazolam drug treatment.To maintain the agitation score (SAS) in the standard state of two~four and efficiency of sedation, the mean arterial pressure (map), respiratory rate (RR), heart rate (HR), oxygen saturation (SpO2), arterial carbon dioxide partial pressure (PaCO2), central venous pressure (CVP) Glasgow Coma Score (GCS) and pharmacoeconomic profiles were tested in all patients.ResultsAll patients in two groups achieved the expected sedative effect and analgesia scores.However, A group showed a greater decrease in MAP, RR and HR after sedation as compared to B group.In two groups, there was no significant difference was observed in pulse oxygen saturation (SpO2),partial pressure of carbon dioxide in artery(PaCO2), central venous pressure(CVP)or GCS score before and after sedation.Dexmedetomidine combined with MI of alprazolam treatment phase compared with dexmedetomidine and propofol regimen is more economical, and the difference has statistical significance (P<0.05).ConclusionThe effects of dexmedetomidine combined with propofol and dexmedetomidine combined with midazolam two regimens can achieve good sedative effect.But combined with propofol group compared to midazolam combined with group of respiratory and circulatory system have better inhibitory effect, also in drug economics angle, midazolam midazolam combined with group than that of propofol combined with group is more economical, patients taking lower cost.

dexmedetomidinepropofolmidazolamtraumatic brain injurysedation

李津、李美珍、王攀

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天津医科大学第二医院 药学部,天津 300382

右美托咪啶 丙泊酚 咪达唑仑 颅脑外伤 镇静作用

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(6)
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