2024 年第 12 期 第 0 卷

氢吗啡酮与地佐辛用于重症监护病房非机械通气患者镇痛效果的随机对照研究

A randomized controlled study of analgesic effect of hydromorphone and dezocine in patients with non-mechanical ventilation in intensive care unit

作者：刘金涛潘显国杨涛赵竹青王绍红

英文作者：Liu Jintao Pan Xianguo Yang Tao Zhao Zhuqing Wang Shaohong

单位：贵州医科大学第二附属医院重症医学科，凯里556000

英文单位：Department of Intensive Care Unit the Second Affiliated Hospital of Guizhou Medical University Kaili 556000 China

关键词：非机械通气；重症监护病房；氢吗啡酮；地佐辛；镇痛

英文关键词：Non-mechanicalventilation;Intensivecareunit;Hydromorphone;Dezocine;Analgesia

• 摘要：

• 目的 探讨氢吗啡酮与地佐辛用于重症监护病房（ICU）非机械通气患者的镇痛效果。方法 选取2021年10月至2024年4月贵州医科大学第二附属医院收治的94例ICU非机械通气患者为研究对象，采用单盲试验方法将患者分为对照组和观察组，每组47例。对照组采用地佐辛注射液治疗，观察组采用盐酸氢吗啡酮注射液治疗。比较2组患者的镇痛效果、镇静效果、舒适度、疼痛因子水平、不良事件发生率、治疗安全性。结果 治疗后，观察组在12、24、48、72 h的视觉模拟量表评分、Ricmond躁动镇静评分均低于对照组，差异均有统计学意义（均P<0.05）。治疗后，观察组生理舒适度、心理舒适度、环境舒适度、社会文化舒适度评分均高于对照组，差异均有统计学意义（均P<0.05）。治疗后，观察组环氧合酶2、缓激肽、前列腺素E2水平均低于对照组，差异均有统计学意义（均P<0.001）。观察组不良事件总发生率低于对照组［6.4%（3/47）比21.3%（10/47）］，差异有统计学意义（χ2=4.376，P=0.034）。2组不良反应总发生率比较差异无统计学意义（P=0.726）。结论 与地佐辛相比，氢吗啡酮对于ICU非机械通气患者有更好的镇痛镇静效果，可提高患者的舒适度，降低疼痛因子水平，降低不良事件发生率，且治疗安全性良好。

• Objective To investigate the analgesic effects of hydromorphone and dezocine in patients with non-mechanical ventilation in intensive care unit (ICU). Methods A total of 94 ICU patients with non-mechanical ventilation admitted to the Second Affiliated Hospital of Guizhou Medical University from October 2021 to April 2024 were selected as the research objects. The patients were divided into control group and observation group by single-blind test method, with 47 cases in each group. The control group was treated with dezocine injection, and the observation group was treated with hydromorphone hydrochloride injection. The analgesic effect, sedative effect, comfort, pain factor levels, incidence of adverse events, and treatment safety were compared between the two groups.Results After treatment, the visual analogue scale score and Ricmond agitation sedation score at 12, 24, 48 and 72 h in the observation group were lower than those in the control group (all P<0.05). After treatment, the physiological comfort, psychological comfort, environmental comfort, social and cultural comfort scores of the observation group were higher than those of the control group (all P<0.05). After treatment, the levels of cyclooxygenase-2, bradykinin and prostaglandin E2 in the observation group were lower than those in the control group (all P<0.001). The total incidence of adverse events in the observation group was lower than that in the control group ［6.4%(3/47) vs 21.3%(10/47)］(χ2=4.376, P=0.034). There was no significant difference in the total incidence of adverse reactions between the two groups (P=0.726). Conclusion Compared with dezocine, hydromorphone has better analgesic and sedative effect for ICU patients without mechanical ventilation, which can improve the comfort of patients, reduce the level of pain factors, reduce the incidence of adverse events, and has good safety.