【摘要】 目的探讨镇静治疗对重症监护病房(ICU)中危重患者应激反应的影响。方法80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。分别监测其用药前、用药后12、24h血糖(Glu)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)浓度和胃液pH值。结果A、B两组接受镇静治疗后12、24h,Glu、Cor和ACTH水平与镇静治疗前相比明显下降(P<0.05),胃液pH值明显升高(P<0.05)。结论对危重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,从而预防应激性溃疡的发生。更多还原

【Abstract】 Objective To study the effect of sedation on stress response in severe patients in ICU.Methods Eighty patients were with acute physiology and chronic health evaluation(APACHEⅡ)≥16,and were randomly received either midoxolam and fentanyl(group A) or propofol plus fentany(group B) with micro pump infusion for sedation at level of Ramsay score of 2 to 5.Before infusion,12h after infusion and 24h after infusion;Venous blood samples were taken for the measurements of glucose(Glu),cortisol(Cor) and ACTH before infusion,at 12h and 24h during sedation.pH value in gastric fluids was measured as well.Results Compared to the data before infusion,Glu,Cor and ACTH were significantly decreased and pH in gastric fluids was gradually increased at 12h and 24h during sedation in two groups(P<0.05).Conclusion Effective sedation and analgesia therapy can effectively reduce the stress response and increase pH value in gastric fluids,which is benificial to preventing the development of stress ulcer in critical patients.更多还原