丙泊酚复合芬太尼对老年机械通气患者血液动力学的影响

目的观察联合应用丙泊酚和芬太尼对ICU中老年机械通气患者血液动力学的影响。方法30例入住ICU老年机械通气患者随机分为丙泊酚复合芬太尼组（P＋F组，n=15）和丙泊酚组（n=15），P＋F组持续静脉泵入芬太尼和丙泊酚，丙泊酚组持续泵入丙泊酚。根据Ramsay评分标准调整镇静药物用量。记录镇静后0、12、24、48h两组患者的平均动脉压（MAP）、HR、心指数（CI）、每搏指数（SI）、心加速指数（ACI）、外周血管阻力指数（SVRI）的变化。结果镇静治疗后，两组患者MAP、HR变化不明显。用药12h后，P＋F组SVRI、丙泊酚组CI、SI、ACI较镇静前均明显降低（P〈0．05），P＋F组SVRI、丙泊酚组cI、SI、ACI降低较对应组更为明显（P〈0．05），用药24h后，丙泊酚组SI、ACI仍低于镇静前（P〈0．05），且低于P＋F组（P〈0．05）。应用镇静48h，P＋F组丙泊酚总用量明显少于丙泊酚组（P〈0．05）。结论与单用丙泊酚镇静相比，丙泊酚复合芬太尼对机械通气的老年患者的血液动力学影响更小，丙泊酚用量更少。

Hemodynamic Effects of Propofol and Fentanyl on Aged Patients During Mechanical Ventilation

Objective The aim of study is to evaluat the effects of the hemodynamic effects of the propofol combined fentanyl on elder patients during mechanical ventilation. Methods Thirty aged patients which were admitted to ICU with mechanical ventilation were randomly divided into two group, P + F group (n = 15) receiving propofol + fentanyl infusion, propofol group(n = 15) receiving only receiving infusion. Then record the MAP、HR、CI、SI、ACI、SVRI before using and 12、24、48 hours after sedation. Results CI、SI and ACI de-creased significantly in propofol group on 12 hours after sedation(P<0.05). The SVRI of P + F group de-creased significantly on the same time (P<0.05). The total volume of using propofol in P + F group was less than the propofol group (P<0.05). Conclusion Compare using propofol alone, propofol combined fentanyl could provide satisfactory sedation for aged patients during mechanical ventilation with little hemodynarnic chan-ges and lesser volume of using propofol.