异丙酚用于心脏术后机械通气患者中的镇静效果观察及护理  

Sedative effect of propofol in patients undergoing mechanical ventilation after heart operation and related nursing care

作　　者：孔海燕[1] 郑跃[1] 方振红[1] 

机构地区：[1]温州医学院附属第一医院ICU,325000

出　　处：《中国急救复苏与灾害医学杂志》2010年第4期350-353,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨异丙酚在心脏术后机械通气患者中的的镇静效果及护理。方法选择40例心脏术后气管插管机械通气患者，术毕入重症监护室有苏醒反应时，先给予异丙酚0．6～1．0mg／kg诱导后，再以0．6～4mg／（kg·h）速度微量注射泵持续静脉泵入，动态监测给药前、后和停药时呼吸、循环参数的变化，观察异丙酚起效时间、停药后苏醒时间，并与治疗前进行比较。结果异丙酚起效时间（27．7±8．5）s维持在预期目标Ramsay分级Ⅲ-Ⅳ级，有效率达到100％。用药持续时间（30．5±23．5）h，停药唤醒时间（15．1±5．3）min。停药清醒后再入睡者2例，给予床旁反复语言刺激后不再入睡。尤恶心、呕吐等不良反应发生。本组40例患者用药前均存在人机对抗，自主呼吸频率快，血氧饱和度下降，在排除了呼吸道因素外，用药后呼吸频率、血氧饱和度有明显改善，与用药前比较（P〈0．05或P〈0．01，差异有统计学意义。循环系统方面血压波动、心率增快等表现也有一定的改善。结论心脏术后机械通气患者应用异丙酚镇静不仅起效快，能达到有效的镇静状态，便于控制镇静深度，而且苏醒快、有利于尽早撤离呼吸机，减少机械通气时间和在ICU住院时间，从而减轻患者痛苦和减少医疗费用。Objective To investigaste the sedative effect of propofol in patients undergoing mechanical ventilation after heart operation and related nursing care thereabout. Methods Propofol 1.0mg/kg was given as induction dose to 40 patients undergoing mechanical ventilation after heart operation who showed awakening reaction and then was infused intraveously at the dose of 0.6- 4mg/（kg. h）. The respiratory and circulatory parameters were monitored dynamically before and after the administration. Results The effect-acting time of propofol was （27.7±8.5）s, the effect was maintained at the Ramsay grades III- IV, and the effect rate was 100%. the maintenance time was （30.5±23.5） h, wake-up time after withdrawal was （15.1 ±5.3）min. No adverse reaction, such as nausea and vomiting, occurred. Fter the admistration the respiration and blood oxygen saturation were improved. Conclusion Propofol is effective for the patients undergoing mechanical ventilation after heart operation

关 键 词：异丙酚 心脏手术 机械通气 镇静 

分 类 号：R631.2[医药卫生—外科学] R364.5[医药卫生—临床医学]