靶控输注异丙酚在ICU危重病人中的应用研究  

The Clinical Study of the Prophylaxis Effect of Target Controlled Infusion with Propofol on Severe Patients in Intensive Care Unit

作　　者：张玮[1] 夏婧[1] 钱传云[1] 

机构地区：[1]昆明医学院第一附属医院急诊科ICU,昆明650032

出　　处：《中国医药导刊》2010年第1期45-46,117,共3页Chinese Journal of Medicinal Guide

基　　金：云南省自然科学基金资助项目(2008ZC120M)

摘　　要：目的:探讨以靶控制输注(TCI)异丙酚在ICU危重病人中的应用。方法:将120例入住我科ICU病房,APACHEⅡ评分≥16分的患者随机分为对照组和试验组。对照组(A组)使用咪达唑仑(Midazolam)+芬太尼(Fendanyl)进行镇静、镇痛治疗;试验组(B、C组),其中B组使用异丙酚(Propofol)+芬太尼按传统方法进行镇静、镇痛治疗;C组使用TCI泵输注异丙酚+芬太尼进行镇静、镇痛治疗。使患者Ramsay评分控制在(2～5)分。各组分别在用药前、用药后12、24小时记录心率(HR)、平均动脉压(MAP)。结果:A组病人24小时内,患者MAP和HR与治疗前相比差异无显著性(P>0.05);B组患者24小时内,病人MAP和HR与治疗前相比即出现下降,结果有统计学差异(P<0.05);C组病人4小时内,病人MAP和HR与治疗前相比未出现明显变化(P>0.05)。结论:使用TCI技术输注进行镇静治疗与传统恒速输注方法相比,在提供更为稳定的血药浓度,提高镇静的可控性与灵活性的同时,能有效避免其对心血管系统的抑制作用。Objective：To study the sedation effect of target controlled infusion with Propofol on Severe Patients in Intensive Care Unit. Methods： 120 patients underwent the acute physiology and chronic health evaluation （APACHE）, with APACHE Ⅱ≥16. were randomly divided into three groups： Group A was contrasting group, use Midoxolam and Fentanyl for pain controlling and sedation with micro pump infusion system; Group B was the group of Propofol and Fentanyl with micro pump infusion system; Group C was the group of Propofol and Fentanyl with target controlled infusion（TCl）, controlling the Patients＇ Ramsay Score between 2 to 5. HR and MAP were monitored before infusion. 12hours after infusion and 24 hours after infusion were measured each time. Results：MAP and HR have no significant difference before and after infusion in group Atin 24 hours）： MAP and HR were decreased and have significant difference before and after infusion in group B（P〈0.05k MAP and HR have no significant difference before and after infusion in group COn 24 hours）（P）0.05） Conclusion ：Compared to the traditional continuing infusion methods. TCI technique can provide more stable blood concentration, increase the agility and controllability of sedation and effectively avoid the suppression of the cardiovascular system.

关 键 词：靶控输注 异丙酚 ICU 镇静 

分 类 号：R614.24[医药卫生—麻醉学]