摘要
目的观察丙泊酚镇静对严重脓毒症及脓毒症休克患者呼吸力学及氧合的影响。方法 42例实施机械通气的严重脓毒症及脓毒症休克患者随机分为丙泊酚(P)组(镇静诱导和维持用丙泊酚)和咪唑安定(M)组(镇静诱导和维持用咪唑安定)。根据Ramsay氏分级标准调整2组用药量。记录2组患者镇静诱导前即刻(T0)、镇静诱导后1h(T1)、12h(T2)、24h(T3)、48h(T4)各时点气道峰压(PIP)、平台压(PPlat)、肺动态顺应性(Cdyn)及气道阻力(Raw),同时采集上述各时点中心静脉血、桡动脉血测定血气,计算肺内静动脉分流率(Qs/Qt)和氧合指数(OI)。结果 (1)与T0时比较,T1～T4时2组患者呼吸参数均有改善(P<0.05);(2)与M组比较,T4时P组Qs/Qt下降、OI升高(P<0.05)。结论丙泊酚镇静有利于改善机械通气时严重脓毒症及脓毒症休克患者氧合,可为其病因治疗赢得时间。
Objective To observe the effect of sedation with propofol on pneumodynamics and oxygenation in mechanically ventilated patients with severe sepsis or septic shock.Methods 41 mechanically ventilated patients with severe sepsis or septic shock were randomly divided into 2 groups：propofol group （group P,n=21） and midazolam group （group M,n=21）.Sedation was induced and maintained with propofol in group P,while midazolam was used in group M.The sedation degree was adjusted according to Ramsay classification standard.Breathing mechanical parameters including PIP,Pplat,Cdyn and Raw were recorded before induction of sedation （To）, lh（Tl）, 12h（T2）,24h（T3）and 48h（T4） after induction of sedation.At the same time,blood samples were taken for blood gases analysis.O1 （PaOJFiO2） and Qs/Qt were calculated.Results （1）Breathing mechanical parameters were improved significantly at T1, T2,T3 and T4 compared with those at TO （P〈0.05）,（2）Compared with group M,Qs/Qt decreased and OI increased significantly at T4 in group P （P〈0.05）.Conclusion Sedation with propofol can improve the oxygenation in mechanically ventilated patients with severe sepsis or septic shock,which can save more time for treatments of the pathogeny.
出处
《中外医疗》
2011年第29期5-6,共2页
China & Foreign Medical Treatment
关键词
丙泊酚
镇静
脓毒症
呼吸力学
氧合
Propofol
Sedation
Sepsis
Oxygenation
Pneumodynamics
