ICU中异丙酚对瓣膜置换病人血流动力学的影响  

The effect of propofol on the hemodynamics of patients after valve replacement in ICU

作　　者：李咏梅[1] 孙晨光[1] 高素心[1] 吴乃石[1] 

机构地区：[1]哈尔滨医科大学附属第二医院心外科,黑龙江哈尔滨150086

出　　处：《哈尔滨医科大学学报》2001年第3期197-199,共3页Journal of Harbin Medical University

摘　　要：目的　进一步探索异丙酚对瓣膜置换术后病人血流动力学的影响 ,找到适用于重症监护中心 (ICU)镇静的最佳用药方案。方法　给瓣膜置换术后病人小剂量持续静脉推注异丙酚 ,同时Swan Ganz漂浮导管监测血流动力学指标。结果　达到适当镇静水平 ,异丙酚剂量为每小时 (1.2 5± 0 .71)mg kg ;HR、SVR、PVR、MPAP、PAWP、LVSWI×HR、RVSWI×HR于 30min较用药前下降 (P <0 .0 5 ) ,CI、SI分别由 (2 .40± 0 .2 9)L (m2 ·min)、(2 3.7± 2 .6 )ml (m2 ·b)上升至 (2 .77± 0 .36 )L (m2 ·min)、(2 9.9± 2 .5 )ml (m2 ·b) (P <0 .0 5 )。结论　①在ICU中小剂量持续静脉推注异丙酚可使心脏术后病人达到适当镇静水平 ;②对于风湿性瓣膜病人 ,异丙酚可降低心率、体循环阻力、肺动脉压力 ,减少心脏每分耗氧量 。Objective To study the effect of propofol on the hemodynamics of patients after valve replacement and to find effective protocol of sedation in ICU. Methods Low dose propofol was given to patients with valve replacements for a suitable level of sedation.Hemodynamic status was determined by Swan Ganz catheter. Results The dose of propofol was (1.25± 0.71)mg/(kg·h). HR,SVR,PVR,MPAP,PAWP LVSWI×HR,RVSWI×HR of propofol group at 30 min had more decrease than before using drugs. CI and SI increased respectively from (2.40±0.29)L/(m 2·min),(23.7±2.6)ml/(m 2·b) to (2.77±0.36)L/(m 2·min),(29.9±2.5)ml/(m 2·b)( P <0.05).Conclusion ①The appropriate sedation can be acquired with the continuous intravenous use of middle or little dosage propofol after cardiac surgery.②Use of propofol can cause to reduse heart rate, reduse resistent of systemic circulation ,reduse pulmonary arterial pressure and can improve heart functions.

关 键 词：异丙酚 血流动力学 监护中心 心脏外科学 ICU 

分 类 号：R654.2[医药卫生—外科学] R971.2[医药卫生—临床医学]