布托啡诺联合右美托咪定在慢性阻塞性肺疾病急性加重期合并呼吸衰竭患者中的应用价值  

Application Value of Butorphanol Combined with Dexmedetomidine in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Respiratory Failure

作　　者：杨林[1] 陈培莉[1] 刘永生[2] YANG Lin;CHEN Peili;LIU Yongsheng(Department of Critical Care Medicine,Shangqiu First People’s Hospital,Shangqiu 476000,China;Neurosurgery,Shangqiu First People’s Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院重症医学科,河南商丘476000 [2]商丘市第一人民医院神经外科,河南商丘476000

出　　处：《河南医学研究》2021年第22期4157-4159,共3页Henan Medical Research

基　　金：国家卫生健康委“十三五”规划全国重点课题(YYWS1852)。

摘　　要：目的探讨布托啡诺联合右美托咪定在接受气管插管治疗的慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者中的应用价值。方法回顾性收集2019年1月至2021年1月商丘市第一人民医院收治的96例AECOPD合并呼吸衰竭患者的临床资料。患者均接受气管插管治疗。根据干预方案将患者分为对照组(47例)和观察组(49例)。对照组患者接受右美托咪定干预。观察组患者接受布托啡诺联合右美托咪定干预。比较两组镇静起效时间、停药后清醒时间、机械通气时间、住ICU时间。采用躁动-镇静评分(RASS)评估镇静效果。采用行为疼痛量表(BPS)评估镇痛效果。比较两组用药前(T_(0))、用药30 min后(T_(1))、用药1 h后(T_(2))患者的生命体征,包括心率(HR)、平均动脉压(MAP)、呼吸频率(VF)。比较两组不良反应发生率。结果观察组镇静起效时间、停药后清醒时间、机械通气时间、住ICU时间较对照组短(P<0.05)。观察组RASS评分较对照组高,BPS评分较对照组低(P<0.05)。T_(0)、T_(1)时,两组HR、MAP、VF比较,差异无统计学意义(P>0.05);观察组T_(2)时HR、MAP、VF低于对照组(P<0.05);两组HR、MAP、VF在T_(0)、T_(1)、T_(2)时呈下降趋势(P<0.05)。观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论布托啡诺联合右美托咪定可缩短接受气管插管治疗的AECOPD合并呼吸衰竭患者的镇静起效时间、停药后清醒时间、机械通气时间以及住ICU时间,提高镇静、镇痛效果,稳定生命体征。Objective To explore the application value of butorphanol combined with dexmedetomidine in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure.Methods The clinical data of 96 patients with AECOPD with respiratory failure admitted to Shangqiu First People’s Hospital from January 2019 to January 2021 were retrospectively collected.All patients received endotracheal intubation treatment.According to the intervention plan,the patients were divided into control group(47 cases)and observation group(49 cases).The patients in control group received intervention of dexmedetomidine.The patients in observation group received intervention of butorphanol combined with dexmedetomidine.The onset time of sedation,awake time after drug withdrawal,mechanical ventilation time and ICU stay time were compared between the two groups.Richmond agitation-sedation scale(RASS)was used to evaluate the effect of sedation.Behavioral pain scale(BPS)was used to evaluate the analgesic effect.The vital signs of the two groups before medication(T_(0)),30 minutes after medication(T_(1))and 1 hour after medication(T_(2)),including heart rate(HR),mean arterial pressure(MAP)and respiratory rate(VF)were compared between the two groups.The incidence of adverse reactions between the two groups was compared.Results The onset time of sedation,awake time after drug withdrawal,mechanical ventilation time and ICU stay time in observation group were shorter than those in control group(P<0.05).The score of RASS in observation group was higher than that in control group,and the score of BPS in observation group was lower than that in control group(P<0.05).At T_(0) and T_(1),there was no statistical difference between the two groups of HR,MAP and VF(P>0.05).At T_(2),HR,MAP and VF in observation group were lower than those in control group(P<0.05).HR,MAP and VF showed a downward trend at T_(0),T_(1) and T_(2) in the two groups(P<0.05).There was no statistical difference in the incidence of adverse reactions be

关 键 词：慢性阻塞性肺疾病急性加重期 呼吸衰竭 气管插管 布托啡诺 右美托咪定 

分 类 号：R563[医药卫生—呼吸系统]