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目的观察丙泊酚注射剂治疗活动过多型谵妄的临床疗效及安全性。方法将100例活动过多型谵妄患者分为对照组48例和试验组52例。对照组先予以负荷剂量1μg·kg~(-1)右美托咪定在10 min内静脉推注,后以0.52~0.70μg·kg~(-1)·h~(-1)持续静脉泵入10 min;试验组先予以0.5 mg·kg~(-1)丙泊酚,静脉推注,后以0.5~1.0 mg·kg~(-1)·h~(-1)持续静脉泵入5 min。2组患者均治疗2 h。观察2组患者的临床疗效和药物不良反应的发生情况。结果治疗后,试验组和对照组的重症谵妄筛查表评分分别为(1.26±0.57),(2.53±0.76)分;总谵妄持续时间分别为(20.15±4.67),(26.46±5.12)h;躁动型谵妄持续时间分别为(8.32±2.48),(12.32±4.14)h;谵妄复发率分别为3.85%,18.75%;机械通气时间分别为(50.65±8.84),(60.67±7.98)h;拔管时间分别为(52.76±7.98),(62.38±8.95)h;住重症监护病房时间分别为(114.59±10.76),(123.43±9.87)h,差异均有统计学意义(P<0.05)。2组患者的药物不良反应以低血压、心动过缓、急性肌张力障碍为主。试验组和对照组的药物不良反应发生率分别为21.15%和27.08%,差异无统计学意义(P>0.05)。结论丙泊酚治疗活动过多型谵妄患者的临床疗效确切,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of propofol injection in treating hyperactive delirium. Methods 100 patients with hyperactive delirium were divided into control group (48 cases) and experimental group (52 cases). The control group received intravenous injection of dexmedetomidine 1 μg · kg -1 at a loading dose of 10 μg · kg ~ (-1) · h ~ (-1) 10 min. The experimental group was given 0.5 mg · kg ~ (-1) propofol by intravenous injection and continuous intravenous infusion of 0.5 ~ 1.0 mg · kg -1 · h -1 min. Two groups of patients were treated for 2 h. The clinical efficacy and adverse drug reactions in two groups were observed. Results After treatment, the scores of severe delirium screening test in the test group and control group were (1.26 ± 0.57) and (2.53 ± 0.76) points, respectively; the duration of total delirium was (20.15 ± 4.67) and (26.46 ± 5.12) h respectively; (8.32 ± 2.48) and (12.32 ± 4.14) h respectively. The recurrence rates of delirium were 3.85% and 18.75%, respectively. The durations of mechanical ventilation were (50.65 ± 8.84) and (60.67 ± 7.98) The time of tube was (52.76 ± 7.98) and (62.38 ± 8.95) h, respectively. The duration of intensive care unit was (114.59 ± 10.76) and (123.43 ± 9.87) h, respectively, with statistical significance (P <0.05). Two groups of patients with adverse drug reactions to hypotension, bradycardia, acute dystonia-based. The incidence of adverse drug reactions in the experimental group and the control group were 21.15% and 27.08%, respectively, with no significant difference (P> 0.05). Conclusion Propofol in the treatment of hyperactive delirium patients with clinical efficacy is exact, and does not increase the incidence of adverse drug reactions.