超声心动图监测苯磺酸瑞马唑仑对加强监护病房机械通气患者心脏结构及功能影响的应用分析  

Application analysis of echocardiography monitoring the effect of remimazolam besylate on cardiac structure and function in mechanically ventilated patients in ICU

作　　者：姚方超 田静朴 赵鹏 Yao Fangchao;Tian Jingpu;Zhao Peng(Department of Ultrasound Medicine,Hebei PetroChina Central Hospital,Langfang Hebei 065000,China;The Department of Intensive Care Medicine,Hebei PetroChina Central Hospital,Langfang Hebei 065000,China)

机构地区：[1]河北中石油中心医院超声医学科,河北廊坊065000 [2]河北中石油中心医院重症医学科,河北廊坊065000

出　　处：《中国医刊》2024年第2期185-190,共6页Chinese Journal of Medicine

基　　金：河北省廊坊市科技支撑计划(2021013043)。

摘　　要：目的探讨超声心动图在监测苯磺酸瑞马唑仑对加强监护病房(ICU)机械通气患者心脏结构及功能影响中的临床应用价值。方法选取2022年1—12月河北中石油中心医院收治的ICU机械通气患者106例,在组间基线特征可比的原则上,采用随机数字表法分为观察组(使用苯磺酸瑞马唑仑镇静)与对照组(使用非苯磺酸瑞马唑仑药物镇静)各53例。比较分析两组患者的基线资料、二维斑点追踪成像(2D-STI)参数、二维应变参数、实时三维超声心动图(RT-3DE)功能参数。结果两组患者性别、年龄、体重指数、美国麻醉医师协会分级、是否合并糖尿病、是否合并高血压、是否合并冠心病、是否合并高脂血症以及病因等基线资料比较差异均无统计学意义(P>0.05)。观察组患者左心室舒张末期前后径、右心室二维面积变化率、三尖瓣环收缩期位移、三尖瓣口舒张期峰值血流速度、三尖瓣环侧壁舒张早期运动速度、三尖瓣环侧壁收缩期运动速度及三尖瓣环侧壁舒张早期运动速度/三尖瓣环壁舒张晚期运动速度均明显高于对照组,右心室Tei指数值明显低于对照组,差异均有统计学意义(P<0.05);而两组患者左心室射血分数、右心室舒张末期基底段横径、三尖瓣环壁舒张晚期运动速度及三尖瓣口舒张期峰值血流速度/三尖瓣环侧壁舒张早期运动速度比较差异均无统计学意义(P>0.05)。观察组患者右室整体纵向应变、收缩期整体纵向应变率及左心房收缩期整体纵向应变率均明显低于对照组,而舒张早期整体纵向应变率明显高于对照组,差异均有统计学意义(P<0.05)。观察组患者左心房前后径、左心房上下径、左心房左右径、左心房最大容积、左心房最小容积均明显低于对照组,左心房总射血分数、左心房主动射血分数、左心房管道功能指数及左心房管道扩张指数均明显高于对照组,差异有统计学意Objective To discuss the clinical application value of echocardiography in monitoring the use of remimazolam besylate sedative drugs in ICU mechanically ventilated patients.Method 106 ICU mechanical ventilation patients admitted to Hebei PetroChina Central Hospital from January 2022 to December 2022 were selected and randomly divided into the observation group(using remimazolam besylate for sedation)53 cases and the control group(using non remimazolam besylate for sedation)53 cases.The two-dimensional speckle tracking imagine(2D-STI)parameters,two-dimensional strain parameters and the real-time three dimentional echocardiography(RT-3DE)functional parameters of two groups of ICU mechanically ventilated patients recorded and analyzed.Result There were no significant differences in gender,age,body mass index,American College of Anesthesiologists classification,whether diabetes mellitus was combined,whether hypertension was combined,whether coronary heart disease was combined,whether hyperlipidemia was combined,and etiology between the two groups(P>0.05).The LVEDD,RV-FAC,TAPSE,E,e,s and e/a in the observation group were significantly higher than those in the control group,RV-Tei was significantly lower than that of control group,with statistical significance(P<0.05).There were no significant differences in LVEF,RVEDD,a and E/e between 2 groups(P>0.05).RV-GLS,GLSRs and GLSRa in observation group was significantly lower than that of control group,while the GLSRe was significantly higher than that of control group,with statistical significance(P<0.05).Anterior and posterior diameter of left atrium,anterior and posterior diameter of left atrium,anterior and posterior diameter of left atrium,LAVmax and LAVmin in observation group were significantly lower than control group,LAEF,LAAEF,LAPFI and LAPEI were significantly higher than control group,with statistical significance(P<0.05).There was no significant difference in LAPEF,LAST and LAVP between 2 groups(P>0.05).Conclusion Echocardiography can effectively evaluate the ch

关 键 词：苯磺酸瑞马唑仑 加强监护病房 机械通气 超声心动图 

分 类 号：R614.2[医药卫生—麻醉学]