不同剂量冬眠合剂对外科机械通气危重患者心肺功能的影响  

The Effection of Cardiopulmonary Function with Different Dose Modified Lytic Cocktail for Patients during Surgery of Mechanical Ventilation

作　　者：许月明[1] 游波[2] 陈虎平[2] 

机构地区：[1]解放军第324医院麻醉科,重庆400020 [2]解放军第324医院心胸外科,重庆400020

出　　处：《中国医药导刊》2013年第6期996-998,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨不同冬眠合剂剂量对外科机械通气危重患者心肺的影响。方法:对外科机械通气超过3天且存活的54例危重患者按照不同冬眠合剂剂量分为三组,采用统计学回顾性分析各项指标变化平均值。结果:三组患者入ICU时一般情况相似,但Ⅲ组(大剂量组)急性生理和慢性健康状态评分(APACHEⅡ)高、氧合指数(OI)、自主呼吸潮气量Vt低。应用冬眠合剂后,Ⅰ组、Ⅱ组、Ⅲ组Rasmay评分分别为(2.22±0.94)、(2.89±0.74)、(3.41±0.51),心率变异性分析(96.77±31.74)ms、(119.11±32.22)ms、(141.71±33.40)ms。气道平台压、气道阻力变化幅度三组无明显差异(P>0.05),但Ⅲ组平均动脉压、中心静脉压、尿量波动幅度较小(P<0.05)。三组患者机械通气时间分别为(72.59±14.23)h、(70.94±15.39)h、(82.06±11.75)h,ICU停留时间分别为(5.35±1.69)d、(5.67±2.05)d、(7.06±1.92)d。结论:冬眠合剂在重症患者镇痛镇静中应用是安全的,且中小等剂量冬眠合剂对机械通气的重症患者心肺功能可能有保护作用。Objective：To explore the effection of cardiopulmonary function with different dose modified lytic cocktail for patients during Surgery of mechanical ventilation.Methods：54 caces of ICU critical patients who received more than three days mechanical ventilation were devided into three groups by different dose modified lytic cocktail and analysed the average of index-change retrospectively by statistics.Results：During three groups there were similitude of the general conditions in the ICU,while Ⅲ group that is the large-dose group,got high acute physiology and chronicity health evaluation Ⅱ（APACHEⅡ）score,low andoxygenation index（OI）and spontaneous breathing tidal volume（Vt）.After lytic cocktail applicated,Rasmay score of Ⅰ,Ⅱ,Ⅲgroups were（2.22±0.94）,（2.89±0.74）,（3.41±0.51）and heart rate variability（HRV） were（96.77±31.74）,（119.11±32.22）,（141.71±33.40）minu-second respectively.And there were no differences of the changing range of airway plateau pressure’s（Pplat） and resistance,but the fluctuation of mean blood pressure,center venous pressure and urine volume in Ⅲ group were less than another groups.The time of Ⅰ,Ⅱ and Ⅲ groups during Surgery of mechanical ventilation were（72.59±14.23）,（70.94±15.39）,（82.06±11.75）h respectively,and in the ICU were（5.35±1.69）,（5.67±2.05）,（7.06±1.92） d respectively.Conclusion：It’s safe pretty to use modified lytic cocktail for patients during Surgery of mechanical ventilation.And when we provide medium or low dose modified lytic cocktail for patients during Surgery of mechanical ventilation,we could get profective effect for cardiopulmonary function of human body possiblily.

关 键 词：冬眠合剂 外科机械通气 心肺功能 危重患者 

分 类 号：R473.6[医药卫生—护理学]