摘要
目的 :观察重症严重急性呼吸系统综合征 (SARS)患者实施无创机械通气的过程中镇静剂对通气疗效的影响。方法 :1 0例重症SARS患者 (男 7例、女 3例 )在无创机械通气时使用多美康 (Dormicum)0 .0 3～ 0 .1 0mg/kg/h,使之处于Ramsay镇静分级 2～ 4级水平。比较用药前后呼吸频率、指尖脉搏血氧饱和度(SPO2 )、血气 (PaO2 、PaCO2 、SaO2 )、心率、平均动脉压及呼吸机吸入氧浓度、吸入及呼出压力 (IPAP、EPAP)。结果 :患者充分镇静后 ,其有关氧合指标 (PaO2 、SaO2 、SPO2 )均显著升高 (P <0 .0 1 ) ,CO2 显著升高 (P <0 .0 1 ) ,呼吸频率降低 (P <0 .0 1 ) ,呼吸机设定条件 (FiO2 、IPAP、EPAP)有下降趋势 ,心率降低 ,血压稳定。结论 :重症SARS患者无创机械通气时合理使用镇静剂可改善患者的氧合状态。
Objective:To observe the effects of sedation on the critical severe acute respiratory syndrome(SARS) patients undergoing noninvasive mechanical ventilation(NIMV) treatment.Methods:10 critically ill SARS patients (7m,3f) in ICU were included in this study.They were all received continuous intravenous infusion of Domicum at rate of 0.03-1.0mg/kg and maintained at 2 4 level of Remsay sedation scale .Aterial blood gas analysis was measured before and after sedation,parameters of ventilator (IPAP, EPAP,FiO 2 ), RR and MAP were recorded before and after sedation.Results:PaO 2, SaO 2 ,SpO 2and PaCO 2 were significantly increased and FiO 2,EPAP and IPAP were decreased after sedation with statable MAP and RR.Conclusion:Satisfied sedation on SARS patients during NIMV treatment could improve the oxgenation of the SARS patients and may be decrease the chances of intubation and tracheotomy.
出处
《中日友好医院学报》
2003年第3期131-133,共3页
Journal of China-Japan Friendship Hospital
