丙泊酚联合舒芬太尼在呼吸衰竭患者有创序贯机械通气治疗中的临床应用  

Effect of propofol combined with sufentanil on invasive sequential mechanical ventilation in patients with respiratory failure and its effect on blood gas,plasma BNP and pulmonary artery pressure

作　　者：何修玉 吴泽华 李跃东 李壮丽 He Xiuyu;Wu Zehua;Li Yuedong;Li Zhuangli(Department of Critical Care Medicine,No.105 Hospital of Chinese People′s Liberation Army,Hefei 230031,China)

机构地区：[1]中国人民解放军105医院重症医学科,合肥230031

出　　处：《中华肺部疾病杂志（电子版）》2018年第6期670-673,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金青年科学基金项目(81200171)

摘　　要：目的探讨丙泊酚联合舒芬太尼在呼吸衰竭患者有创序贯机械通气治疗中的临床应用,以及对患者血气、血浆脑钠肽含量、肺动脉压的影响。方法选择2013年5月至2017年8月我院收治的呼吸衰竭患者58例,患者均接受有创序贯机械通气治疗,区分麻醉方式,根据药物禁忌症、过敏史等将58例呼吸衰竭患者分为2组。对照组24例接受丙泊酚麻醉,研究组34例接受丙泊酚联合舒芬太尼麻醉,测定患者血气、血浆脑钠钛、肺动脉压指标,并作对比分析。结果两组患者镇静时肺动脉压指标、血浆脑钠肽含量无统计学意义(P>0.05);镇静6、12 h时肺动脉压指标、血浆脑钠肽含量,研究组低于对照组,组间比较有统计学意义(P<0.05)。对比两组患者血气指标p H、PaO2、PaCO_2,镇静时无统计学意义(P>0.05);镇静6、12 h时,研究组p H、PaO2指标高于对照组,PaCO_2指标低于对照组,组间比较有统计学意义(P<0.05)。对比两组患者并发症总发生率,研究组6.90%低于对照组27.58%,组间比较有统计学意义(P<0.05)。结论丙泊酚联合舒芬太尼在呼吸衰竭患者有创序贯机械通气治疗中应用效果明显,其镇痛、镇静作用突出,可促进肺动脉压、血浆脑钠肽、血气指标改善。Objective To study the effect of propofol combined with sufentanil on the treatment of patients with respiratory failure with bed sequential mechanical ventilation and its effect on blood gas,plasma BNP and pulmonary artery pressure.Methods All 58 patients with respiratory failure enrolled in our hospital from May 2013 to August 2017 were randomly selected and divided into two groups according to the random number method.The patients were treated with invasive sequential mechanical ventilation.The control group(24 cases)received propofol anesthesia,the study group(34 cases)received propofol and sufentanil anesthesia,blood gas,plasma BNP and pulmonary arterial pressure indicators were measured,compared and analyzed.Results Compared with the two groups,the pulmonary artery pressure index and plasma BNP content were not statistically significant(P>0.05).Compared with the control group,the data of pulmonary arterial pressure and plasma BNP were lower than those in the control group at 6 h and 12 h after anesthesia(P<0.05).There was no significant difference in blood gas(pH,PaO2,PaCO2)between the two groups at the time of sedation(P>0.05).At 6 h and 12 h after sedation,the values of pH and PaO2 in the study group were higher than those in the control group,and the PaCO2 index was lower than that of the control group.The data were statistically significant(P<0.05).The total incidence of complications was compared between the two groups,the study group was 6.90%,which was lower than the control group of 27.58%,and the data between the two groups were statistically significant(P<0.05).Conclusions Propofol combined with sufentanil was effective in the treatment of invasive sequential mechanical ventilation in patients with respiratory failure.The analgesic and sedative effects were prominent and promoted the improvement of pulmonary artery pressure,plasma BNP and blood gas,and the application value is high.

关 键 词：呼吸衰竭 有创序贯机械通气 丙泊酚 舒芬太尼 

分 类 号：R563[医药卫生—呼吸系统]