盐酸氢吗啡酮在纤维支气管镜支气管肺泡灌洗治疗呼吸机相关性肺炎中的应用效果  

Application of hydromorphone hydrochloride in the treatment of ventilator-associated pneumonia by bronchoalveolar lavage with bronchoscopy

作　　者：张丽 ZHANG Li(Department of Respiratory and Critical Care Medicine,Yuanzhou District People's Hospital of Guyuan,Guyuan,Ningxia 756000,China)

机构地区：[1]固原市原州区人民医院呼吸与危重症医学科,宁夏固原756000

出　　处：《医药前沿》2025年第9期74-77,共4页Journal of Frontiers of Medicine

摘　　要：目的探讨盐酸氢吗啡酮在纤维支气管镜支气管肺泡灌洗治疗呼吸机相关性肺炎(VAP)中的应用效果。方法选择固原市原州区人民医院2020年5月—2023年12月行纤维支气管镜支气管肺泡灌洗治疗的VAP患者70例,采用随机数字表法分为观察组和对照组,每组35例。观察组采用氢吗啡酮复合丙泊酚麻醉,对照组采用芬太尼复合丙泊酚麻醉。比较两组患者血流动力学变化,记录术中退镜情况、丙泊酚用量及苏醒时间,术后采用视觉模拟评分法(VAS)进行疼痛评估,记录不良反应。结果两组术中心率、平均动脉压、脉搏血氧饱和度均发生变化,但组间差异无统计学意义(P>0.05)。观察组术中因呼吸抑制导致退镜的比例为11.43%,对照组为14.29%,差异无统计学意义(P>0.05)。观察组丙泊酚用量少于对照组(P<0.05);两组苏醒时间及苏醒时VAS评分比较,差异无统计学意义(P>0.05);术后30、60min时观察组VAS评分低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论盐酸氢吗啡酮用于VAP患者支气管肺泡灌洗治疗的全身麻醉安全可行,可有效维持循环稳定,减少丙泊酚用量,并延长镇痛时效。Objective To investigate the application value of hydromorphone hydrochloride in the treatment of ventilatorassociated pneumonia(VAP)by bronchoalveolar lavage with fiberoptic bronchoscopy.Methods A total of 70 VAP patients who received bronchoalveolar lavage with fiber bronchoscopy in Yuanzhou District People's Hospital of Guyuan from May 2020 to December 2023 were selected and divided into observation group and control group by random number table method,with 35 cases in each group.The observation group was anesthetized with hydromorphone combined with propofol,and the control group was anesthetized with fentanyl combined with propofol.The hemodynamic changes of the two groups were compared,and the intraoperative withdrawal situation,propofol dosage and recovery time were recorded.Postoperative Visual Analogue Scale(VAS)was used to evaluate pain and record adverse reactions.Results There were significant changes in operative center rate,mean arterial pressure and pulse oxygen saturation between the two groups,but there was no significant difference between the two groups(P>0.05).The proportion of endoscopic removal due to respiratory depression was 11.43%in the observation group and 14.29%in the control group,the difference was not statistically significant(P>0.05).The dosage of propofol in the observation group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the recovery time and VAS score between the two groups(P>0.05),and the VAS score in the observation group was significantly lower than that in the control group at 30 and 60 min after surgery(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions It is safe and feasible to use hydromorphone hydrochloride for general anesthesia of bronchoalveolar lavage in VAP patients,which can effectively maintain circulation stability,reduce the dosage of propofol,and prolong analgesia.

关 键 词：盐酸氢吗啡酮 全身麻醉 呼吸机相关性肺炎 纤维支气管镜 支气管肺泡灌洗 

分 类 号：R563[医药卫生—呼吸系统]