盐酸纳布啡在无创正压通气中的应用及安全性研究  

Study on the Application and Safety of Nalbuphine Hydrochloride in Non-invasive Positive Pressure Ventilation

作　　者：曾迎春[1] 何佩娟[1] 杨银妹[1] 张齐龙[1] 胡小萍[1] 章玉坤[1] 杜凌燕 蔡源恩 赖语章 ZENG Yingchun;HE Peijuan;YANG Yinmei;ZHANG Qilong;HU Xiaoping;ZHANG Yukun;DU Lingyan;CAI Yuanen;LAI Yuzhang(Jiangxi Provincial Chest Hospital,Nanchang 330006,China;不详)

机构地区：[1]江西省胸科医院,江西南昌330006

出　　处：《中国医学创新》2022年第6期115-119,共5页Medical Innovation of China

基　　金：江西省卫生健康委员会科技计划项目(20204752)。

摘　　要：目的:探讨盐酸纳布啡在无创正压通气中的应用价值及安全性。方法:选择2020年1月-2021年4月江西省胸科医院重症监护室收治的年龄≥18岁、需无创通气、有镇痛镇静需求的患者80例,按随机数字表法将其分为观察组和对照组,各40例。观察组使用盐酸纳布啡,对照组使用咪达唑仑。比较两组治疗过程中重症监护患者的疼痛评估(CPOT)和Richmond躁动镇静评分(RASS)变化情况,比较两组治疗过程中生命体征指标,比较两组低氧血症、高碳酸血症、低碳酸血症、谵妄及焦虑发生率,比较两组无创通气有效率、气管插管率,统计两组无创通气时间、无创通气舒适度及ICU入住时间。结果:观察组治疗4、6、12和24 h后CPOT评分及RASS评分均低于同期对照组(P<0.05)。治疗2、24 h后及脱机24 h后,观察组呼吸频率、心率及平均动脉压均低于对照组(P<0.05)。观察组低氧血症、高碳酸血症、低碳酸血症、谵妄及焦虑的发生率均显著低于对照组(P<0.05)。观察组无创通气有效率高于对照组,气管插管率低于对照组(P<0.05)。观察组无创通气时间和ICU入住时间均短于对照组(P<0.05),无创通气舒适度评分低于对照组(P<0.05)。结论:无创通气治疗时使用盐酸纳布啡镇痛镇静,可以避免患者因不能耐受无创通气而气管插管,减少ICU入住时间,提高临床治疗效果。Objective:To explore the application value and safety of Nalbuphine Hydrochloride in non-invasive positive pressure ventilation.Method:A total of 80 patients aged ≥18 years,requiring noninvasive ventilation and requiring analgesia and sedation were selected from the intensive care unit of Jiangxi Provincial Chest Hospital from January 2020 to April 2021,according to the random number table method,they were divided into observation group and control group,40 cases in each group.The observation group was treated with Nalbuphine Hydrochloride and the control group was treated with Midazolam,the pain assessment (CPOT) and the Richmond agitation and sedation score (RASS) changes of the two groups during the treatment process were compared,and the vital signs of the two groups were compared during the treatment process,the incidence of hypoxemia,hypercapnia,hypocapnia,delirium and anxiety were compared between the two groups,the effective rate of non-invasive ventilation and the rate of tracheal intubation were compared between the two groups,the non-invasive ventilation time,non-invasive ventilation comfort and ICU stay time of the two groups were counted.Result:The scores of CPOT and RASS in the observation group were lower than those in the control group at 4,6,12 and 24 h after treatment (P<0.05).After 2 and 24 h of treatment and 24 h after weaning,the respiratory rate,heart rate and mean arterial pressure in the observation group were lower than those in the control group (P<0.05).The incidence of hypoxemia,hypercapnia,hypocapnia,delirium and anxiety in the observation group were significantly lower than those in the control group (P<0.05).The effective rate of non-invasive ventilation in the observation group was higher than that in the control group,and the rate of tracheal intubation was lower than that in the control group (P<0.05).The time of non-invasive ventilation and ICU stay in the observation group were shorter than those in the control group (P<0.05),and the score of non-invasive ventilation comfort

关 键 词：盐酸纳布啡 无创正压通气 疼痛评估 躁动镇静评分 无创通气有效率 气管插管率 

分 类 号：R969[医药卫生—药理学]