右美托咪定与异丙酚在ICU有机磷农药中毒机械通气患者中的应用  

The Application of Patients with Organophosphorus Pesticide Poisoning in Mechanical Ventilation with Propofol and Dexmedetomidine in ICU

作　　者：雷贤英[1] 李雨昕[2] 雷贤蓉 胡丽蓉[1] 薛钰婷[1] 

机构地区：[1]泸州医学院附属医院,四川泸州646000 [2]泸州医学院

出　　处：《中外医学研究》2015年第36期3-6,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:对ICU有机磷农药中毒发生呼吸衰竭患者在机械通气期间用右美托咪定与异丙酚的镇静效果观察。方法:56例有机磷农药中毒发生呼吸衰竭机械通气患者随机分成右美托咪定组(28例)和异丙酚组(28例),观察用药前、用药后患者的心率、呼吸、血压、气道压力、氧合指数等参数的变化并进行比较。结果:右美托咪定和异丙酚对有机磷农药中毒发生呼吸衰竭机械通气患者均能够有效镇静,能够降低气道压力,稳定心率和循环,用药后患者心率、血压、呼吸次数、氧合指数均有明显改善(P<0.05);异丙酚组起效时间短,镇静作用强,右美托咪定组呼吸抑制作用较小(P<0.05),降心率作用更明显(P<0.05)。结论:右美托咪定和异丙酚均是ICU有机磷农药中毒呼吸衰竭患者使用机械通气时的理想镇静剂;异丙酚起效更快,镇静作用更强,右美托咪定作用相对缓和,有较明显的降心率作用,呼吸抑制作用较弱。Objective： To study the effect of sedative of Dexmedetomidine and Propofol in mechanical ventilation patients with organophosphorus pesticide poisoning in ICU.Method： 56 patients of organophosphorus pesticide poisoning in mechanical ventilation were randomly divided intoDexmedetomidine group（28 cases） and Propofol group（28 cases）.The HR, RR, SBP, DBP, Airway Pressure, Oxygenation index of patients were measured before treatment and after treatment, then the results were compared.Result： Effective sedation with Dexmedetomidine and Propofol were displayed in two groups, and airway pressure was reduced, heart rate and circulation were stabled, the HR, BP, RR and Oxygenation index were both changed significantly（P〈0.05）.The onset time in Propofol group was quickly than Dexmedetomidine group, the effect of sedation in Propofol group was more obvious than Dexmedetomidine group, the effect of respiratory depression was relatively small and the effect of lowering heart rate was more obvious in Dexmedetomidine group（P〈0.05）.Conelusion： Dexmedetomidine and Propofol are ideal sedative drugs in patients with organophosphorus pesticide poisoning with respiratory failure in mechanical ventilation in ICU.The onset time in Propofol are quickly than Dexmedetomidine, the effect of Sedation is more obvious.And the effect of respiratory depression is relatively small and the effect of lowering heart rate is more obvious in Dexmedetomidine.

关 键 词：右美托咪定 异丙酚 ICU 有机磷农药中毒 机械通气 

分 类 号：R614[医药卫生—麻醉学]