摘要
目的 观察异丙酚、芬太尼用于接受呼吸机治疗重症哮喘患者的镇静效果 ,以及在用药期间血压、心率、血氧饱和度的变化 ,与传统使用氯丙嗪异丙嗪的镇静效果比较 ,是否具有优越性。方法 选择接受呼吸机治疗的重症哮喘患者 40例 ,随机分为芬太尼异丙酚组 (观察组 )和氯丙嗪异丙嗪组 (对照组 ) ,观察组静推芬太尼 2 μg/kg、异丙酚 2～ 3mg/kg诱导 ,然后用微量泵持续注射异丙酚 6～8mg/ (kg·h)维持 ,根据患者的镇静程度作调整 ,对照组在上机前静推氯丙嗪异丙嗪各 1mg/kg。分别记录二组病例在用药前后的HR、BP、SpO2 、停药后清醒时间、清醒后再入睡、对呼吸机的拮抗以及肢体不自主的躁动情况。结果 观察组镇静效果良好 ,HR、BP与用药前比较均有下降 (P <0 .0 5 ) ,对照组HR比用药前增快 ,呼吸机治疗期间有躁动及对呼吸机的拮抗现象。结论 芬太尼、异丙酚用于使用呼吸机治疗的重症哮喘患者 ,可获得满意的镇静效果 ,与氯丙嗪异丙嗪相比 ,更能耐受气管插管及机械通气。
Objective To observe the sedative effects of Propofol and fentanyl in severe asthma with respirator and the changes of blood pressure(BP)、heart rate(HR)、oxygen of saturation of blood compared with the traditional use of chlorpromazine and phenergan. Methods 40 cases of severe asthma with respirator were randomly divided into two groups: Propofol and fentanyl group (group 1)and chlorpromazine and phenergan group (group 2). In group1,the induction was given by venous injection of fantanyl (2μg/kg),and Propofol (2～3mg/kg)first, then Propofol was maintained by continuously injection (6～8mg/kg·h) of micropurnp adjusted by the sedate degree of patients. In group2, chlorpromazine and phenergan were given by venous injection(1mg/kg) before using of respirator.The HR、BP、Spo 2 ,the sober time after drug stopped, resleeping after regaining consciousness, the situation of involuntary restlessness of limp and the antagoning of respirator were recorded in two groups. Results The sedative effect of group1 was better, HR and BP were decreased than that of before administration ,(P<0.05). In group2, HR was more quickly than that of before administration, there were the situation of restlessness and antagoning during the treatment of respirator. Conclusion The satisfied sedative effect can be obtained by Propofol and fentanyl in severe asthma with respirator, It can be more easily stand for tracheal intubation and mechanical ventilation compared with chlorpromazine and phenergan.
出处
《中国煤炭工业医学杂志》
2003年第6期551-552,共2页
Chinese Journal of Coal Industry Medicine
关键词
重症哮喘
异丙酚
芬太尼
呼吸机
治疗
镇静效果
propofol
fentanyl
chlorpromazine
phenergan
mechanical ventilation
severe Asthma
