右美托咪定用于急性左心衰无创正压通气效果观察  

作　　者：胡超娅[1] 周文玲[1] 

机构地区：[1]四川省成都市第二人民医院ICU,四川成都610017

出　　处：《实用中医药杂志》2014年第8期762-764,共3页Journal of Practical Traditional Chinese Medicine

摘　　要：目的:观察右美托咪定用于急性左心衰无创正压通气的效果及并发症发生情况。方法:43例分为右美托咪定组、丙泊酚组和对照组,3组抗心衰药物方案相同,在此基础上使用BiPAP无创呼吸机辅助呼吸。结果:右美托咪定组、丙泊酚组上机后30min、60min氧和指数、SpO2明显高于对照组(P<0.05);右美托咪定组和丙泊酚组30min、60min HR、RR较对照组低(P<0.05);右美托咪定组和丙泊酚组30min、60minHR、RR、SpO2、氧和指数差异无统计学意义(P>0.05);120 min3组生命体征、氧和指数差异无统计学意义(P>0.05);右美托咪定组无创通气时间明显短于其他两组(P<0.05),丙泊酚组和对照组无创通气时间差异无统计学意义(P>0.05);右美托咪定组和丙泊酚组VAS评分明显低于对照组(P<0.05),右美托咪定组和丙泊酚组VAS评分差异无统计学意义(P>0.05);无创改有创通气率右美托咪定组明显低于丙泊酚组和对照组(P<0.05),丙泊酚组和对照组无创改有创通气率差异无统计学意义(P>0.05);3组病死率差异无统计学意义(P>0.05)。结论:急性左心衰无创正压通气应用右美托咪定镇静能短期内改善氧和、稳定生命体征,缩短无创通气时间,提高治疗舒适度,未增加气管插管有创通气率和病死率,安全有效。Objective： To investigate the therapeutic effect of using dexmedetomidine in Sedation Practices during NPPV for patients with acute left heart failure.Methods： Forty patients with acute left heart failure （ Grade IV heart function ） were randomly divided into 3 groups.Patients in all 3 groups accepted supportive treatment included cardiotonics, diuretics, vasodilator, and non- invasive positive pressure ventilation （ NPPV ） were given by biphasic positive airway pressure （ BiPAP ） .Results ： Dexmedetomidine and propofol group＇ s oxygen index, SpO2 were significant higher than control group after 30, 60 minutes treatment （ P〈0.05 ） , dexmedetomidine and propofol group＇ s HR, RR were significant lower then control group after 30, 60 minutes treatment （P〈0.05） .There was no significant difference of HR, RR, MAP, SpO2, oxygen index of 3 groups after 120 minutes treatment （P〉0.05） .Dexmedetomidine and propofol group＇ s VAS score were significant lower than control group （P〈0.05） . Dexmedetomidine group＇ s conversion rate to invasive ventilation and time of NPPV were significant lower then the other two groups （P〈0.05） .There was no significant difference of mortality rate of 3 groups （P〉0.05） .Conclusion： Using dexmedetomidine in Sedation might be effective and safe for patients with acute left heart failure.

关 键 词：急性左心衰 无创正压通气 右美托咪定 

分 类 号：R256.214.16[医药卫生—中医内科学]