肌松剂在危重症哮喘机械通气中的疗效观察  

Effects of muscle relaxant on treatment of severe asthma with mechanical ventilation

作　　者：戴山林 孔辉 金宇 

机构地区：[1]南京医科大学第一附属医院呼吸科RICU,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2015年第2期218-221,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的 :回顾性分析肌松剂对危重症哮喘患者机械通气疗效的影响。方法:41例危重症哮喘患者分为肌松组19例,无肌松组2例,肌松组给予肌松剂+常规治疗,无肌松剂组给予常规治疗。观察2组患者气管插管机械通气后2 h血气分析及气道压变化、拔管时间、住院时间;观察肌松剂使用时间<48 h和>48 h的哮喘患者拔管时间及住院时间。结果:肌松组在使用肌松剂2 h的p H值、Pa CO2较无肌松组明显好转(P<0.05),气道峰值压力较无肌松组明显下降(P<0.05),2组Pa O2无明显差异(P>0.05)。肌松组拔管时间与无肌松组比较无统计学差异(P>0.05),肌松组住院时间较无肌松组显著延长(P<0.05)。肌松剂使用>48 h与<48 h相比,拔管时间及住院时间均显著延长(P<0.05)。结论:肌松剂能迅速改善危重症哮喘患者机械通气后的p H值、Pa CO2,明显降低气道峰值压力,但肌松剂使用>48 h会延长拔管时间及住院时间。Objective：To evaluate eflhcts of muscle relaxant on treatment of severe asthma with mechanical ventilation by retrospective analysis. Methods：Forty-one patients with severe asthma treated by intubation and mechanical ventilation were divided into muscle relaxants group （muscle relaxants and traditional treatment）and non-muscle relaxants group （traditional treatment only）. The blood gas analysis,airway pressure,extubation time,and hospitalization time were compared between two groups. Moreover,the extubation time and hospitalization time of the patients treated with muscle relaxants more than 48 hours or less than 48 h were analyzed. Results： Compared to the non-muscle relaxants group, the pH value and PaCO2 of arterial blood in muscle relaxants group were significantly improved （P 〈 0.05）,the peak pressure of airway was significantly decreased （P 〈 0.05）2 h alter muscle relaxants treatment. No difference was fimnd in PaO2 between two groups. The hospitalization time was shorter in the non-muscle relaxants group （P 〈 0.05）,while no difference was found in extubation time between two groups. Notably,when using muscle relaxants more than 48 h,both extubatiou time and hospitalization time were significantly increased. Conclusion：Muscle relaxants can rapidly improve the pH value,decreased the PaCO2 and peak pressure of airway in severe asthma patients after mechanical ventilation. However,they would increase extubation time and hospitalization time.

关 键 词：肌松剂 危重症哮喘 机械通气 

分 类 号：R562.25[医药卫生—呼吸系统]