摘要
目的机械通气对慢性阻塞性肺病(COPD)有创通气的患者进行镇静镇痛治疗.方法将265例COPD急性加重期有创通气治疗的患者随机分为两组,常规治疗基础上加用咪达唑仑组126例及咪达唑仑联用吗啡组139例,比较两组机械通气的疗效及咪达唑仑的用量.结果机械通气期间联用吗啡组患者与对照组比较,心率、呼吸频率、二氧化碳分压和气道阻力降低,而氧分压则升高,且咪达唑仑用量、平均通气时间、ICU入住时间少于对照组,脱机成功率高于对照组,两组经比较差异有统计学意义(P<0.05).结论对COPD有创通气患者进行控制性的镇静、联合镇痛治疗可以获得满意的镇静镇痛及机械通气效果,同时明显减少镇静剂的用量,缩短患者的平均通气时间、ICU入住时间,提高脱机成功率.
Objective To give sedation analgesia treatment to chronic obstructive pulmonary disease （COPD） patients with invasive ventilation and observe the efficacy of mechanical ventilation. Methods 265 COPD patients in acute exacerbation who were treated with invasive ventilation were randomly divided into two groups： Conventional therapy plus midazolam group （126 cases） and midazolam combined with morphine group （139 cases）. The efficacy of mechanical ventilation and the usage amount of midazolam were compared between two groups. Results Compared with control group, the heart rate, respiratory rate, partial pressure of carbon dioxide and airway resistance decreased in patients who received morphine during mechanical ventilation, while the partial pressure of oxygen increased. And the amount of midazolam, the average ventilation time, ICU stay were less than the control group, the success rate of removing ventilator was higher, difference between the two groups was significant （P 〈 0.05）. Conclusion Controlled sedation and analgesia treatment in COPD patients who received invasive ventilation can obtain satisfactory analgesic and sedative effects and mechanical ventilation effects, meanwhile, significantly reduce the amount of sedatives, shorten the patient＇s average ventilation time, ICU stay time and improve the success rate of removing ventilator.
出处
《昆明医学院学报》
2011年第11期115-117,共3页
Journal of Kunming Medical College
关键词
咪达唑仑
吗啡
慢性阻塞性肺病
有创通气
Midazolam
Morphine
Chronic obstructive pulmonary disease
Invasive ventilation
