目的 探討鹽酸右美托咪定對(duì)ICU患者氣管插管應(yīng)激性反應(yīng)的影響。方法 選取解放軍昆明總醫(yī)院2015年1月-2016年1月ICU病房收治的危重癥患者76例作為研究對(duì)象，按隨機(jī)數(shù)字表法分為對(duì)照組和觀察組，每組38例，兩組均于氣管插管前進(jìn)行橈動(dòng)脈穿刺，并建立靜脈通道，觀察組靜脈泵注鹽酸右美托咪定0.5 μg/kg，持續(xù)10 min，對(duì)照組靜脈泵注等量生理鹽水，隨后兩組均靜脈滴注適量順-阿曲庫銨和丙泊酚。觀察兩組麻醉用藥劑量；檢測(cè)兩組插管前（T₁）、插管后（T₂）、插管后3 min（T₃）及插管后5 min（T₄）時(shí)刻患者動(dòng)脈壓（MAP）、心率（HR）、血漿皮質(zhì)酮水平的變化。結(jié)果 兩組丙泊酚、順-阿曲庫銨麻醉用藥劑量比較差異不顯著；觀察組T₃、T₄時(shí)刻MAP、HR、血漿皮質(zhì)酮水平均顯著低于對(duì)照組（P<0.05）。結(jié)論 在ICU患者氣管插管中應(yīng)用鹽酸右美托咪定可維持血漿皮質(zhì)醇水平、血流動(dòng)力學(xué)穩(wěn)定。

Objective To investigate the effect of dexmedetomidine on tracheal intubation in patients with ICU. Methods A total of 76 severe cases of patients treated in ICU of Kunming General Hospital of Chinese PLA from January 2015 to January 2016 were selected as the subjects, randomly divided into control and observation groups, 38 cases in each group. The two groups underwent radial artery puncture before the trachea intubation, and the venous passage was established. The observation group received iv infusion of dexmedetomidine hydrochloride (0.5 g/kg) for 10 min, and the control group received iv injection of normal saline. Then the two groups were given iv infusion of appropriate atracurium and propofol. The anesthesia dosages of two groups were observed; The levels of angiosthenia (MAP), heart rate (HR) and plasma corticosterone were detected before intubation (T₁), after intubation (T₂), 3 min after intubation (T₃) and 5 min after intubation (T₄) in two groups. Results Propofol and CIS atracurium anesthesia dose of the two groups had no significant difference. The levels of MAP, HR and plasma corticosterone in observation group were significantly lower than those in the control group at T4 and T3 time (P<0.05). Conclusion Application of dexmedetomidine anesthesia could reduce the stress response in patients with endotracheal intubation in ICU and maintain stable hemodynamics and plasma corticosterone.