镇静治疗对ICU危重患者应激的预防作用[J].pdfVIP

· 64· ．ICU． 镇静治疗对ICU危重患者应激的预防作用 夏婧张玮钱传云 80 【摘要】 目的 探讨镇静治疗对霞症监护病房(ICU)中危苇患者，缸激反应的影响。方法 例ICU病房APACHEII评分≥16分的危重患者随机均分为咪唑安定+芬太尼镇静治疗组(A组) 和丙泊酚+芬太尼镇静治疗组(B组)。使患者Ramsay评分控制在2～5分。分别监测其】}{j药前、用 药后12、24h血糖(Glu)、皮质醇(Cot)、促肾卜．腺皮质激素(ACTH)浓度和胃液pH值。结果人、B 两组接受镇静治疗后12、24h，Glu、Cot和ACTH水平与镇静治疗前相比明硅下降(P0．05)．胃液 pH值明硅升高(Po，05)。结论对危苇患者进行有效的镇静、镇痛治疗，能够降低其过度应激状 态。提高胃液的pH值，扶而预防臆激性溃疡的发生。 【关键词】 镇静；应激；咪唑，安定；丙泊酚 Preventiveeffectofsedationonsevere withstress inICUXIA Wei， patients response Jing·ZHANG TheFtfst Medical QIANChuan—yun，Emergencyof AffiliatedHospitalo{KunmingCollege，Kunming 650032，China To theeffectofsedationonstress insevere in [Abstract]Objectivestudy response patients ICU．Methods werewithacute andchronichealthevaluation(APACHE Eightypatients physiology Ⅱ)≥l6，andwere receivedeithermidoxolamand A)or plus randomly fentanyl(grouppropofol 2 B)withmicro infusionforsedationatlevel0f scoreof tO5．Before fentany(group pump Ramsay takenthe infusion。12 hafterinfusionand24hafterinfusion；VenOusblood were for samples measurementsof ACTHbeforeinfusion。at12hand24h glucose(Glu)．cortisol(Cot)and during valuein fluidswasmeasuredaswelt．Results tothedatabefore sedation．pHgastric Compared ACTHwere decreasedand in ricfluidswas infusion。Glu，Corand significantly pH gast gradually increasedat12hand24h sedationintwo Effectivesedation during groups(P0．05)．Conclusion reducestress andincr