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1、右美托咪噪用于高风险术后气管插管患者舒适性与安全性的研究朱文庆杨明全廖常菊张会礼四川省自贡市第一人民医院ICU四川自贡643000【摘要】冃的:探讨盐酸右美托咪喘用于高风险术后气管插管患者的舒适性护理。方法:NNIS分值≥2分的术后患者100例,随机分为右美托咪唳组和对照组,每组50例进行观察。比较两组患者拔除气管导管前的镇静评分Ramsay和RASS评分,呛咳、躁动、心动过缓、高血压、低血压、呕吐等并发症的发生率;对气管插管的耐受程度。结果:气管拔管时,右美托咪噪组较对照组安静,并能有效沟通,RASS及Ramsay评分两组比较统计学差异显著
2、(P<0.01)o拔管时右美托咪唏组并发症发生率较对照组低。对照组患者在苏醒后绝大多数对气管插管的刺激不能耐受,两组差异显著(P<0.01)o结论:高风险手术患者全麻恢复期应用右美托咪噪镇静,同时结合全方位的护理策略,明显提高了围拔管期的舒适性及安全性。【关键词】右美托咪噪;高风险手术;舒适;安全【中图分类号】R614【文献标识码】B【文章编号11764-8999(2015)7-0449-02Dexmedetomidineusedtostudythehighriskofpostoperativetrachealintubationpatientsc
3、omfortandsafetyZhuWenqingYangMingquanLiaoChangjuetaLIntensiveCareUint,the1stPeoples’Hospital,Zigong,Sichuan,643000[AbstractlObjective:Toinvestigatetheeffectsofdexmedetomidineforhighriskofpostoperativetrachealintubationinpatientswithcomfortcare.Method:TheNNISscoremorethan
4、2pointsafteroperationin100patients,randomlydividedintodexmedetomidinegroupandcontrolgroup,50casesineachgroupwereobserved・ComparisonoftwogroupsofpatientsbeforeextubationsedationscoreofRamsayandRASSscore,theincideneeofrestlessness,bucking,bradycardia,hypertension,hypotension,vom
5、itingandothercomplications;toleraneefortrachealintubation.Result:Trachealextubation,dexmedetomidinegroupthaninthecontrolgroup,quiet,andabletocommunicateeffectively,RASSandRamsayscorebetweenthetwogroupsinastatisticallysignificantdifferenee(P<0.01).Extubationdexmedetomidinegr
6、ouptheincideneeofcomplicationswaslowerthanthatincontrolgroup.Patientsinthecontrolgroupinthewakeofthevastmajorityoftrachealintubationstimulicannotbetolerated,betweenthetwogroupswassignificant(P<0.01).Conelusion:Highriskpatientsinanesthesiarecoveryperiodofoperationapplication
7、ofdexmedetomidinesedation,combinedwithnursingstrategyofall-round,obviouslyimprovesthecomfortandsafetyofextubation.【Keywords]DexmedetomidineHighriskoperation;comfort;safety高风险手术指III类及以上切口,手术复杂、时间超3小吋,麻醉分级(ASA≥III级)的手术。术后多数患者存在呼吸、循环功能不稳定,为保证患者的安全,需要重症监护。而全麻插管患者苏醒期躁动或不合作较常见,具有
8、潜在危险,尤其是高风险术后患者更容易发生心血管恶性事件,如高血压、低血压、恶性心律失常、心衰、出血等严重并发症[1]o在I