右美托咪啶联合布托啡诺在慢性阻塞性肺疾病无创通气中的应用研究

目的 考察右美托咪定联合布托啡诺注射液在慢性阻塞性肺疾病急性加重患者无创通气过程中的作用。方法 120例慢性阻塞性肺病合并II型呼衰患者接受无创呼吸机辅助呼吸,随机分为两组,其中试验组60例,无创通气治疗过程中接受右美托咪定联合布托啡诺镇静镇痛;对照组60例,无创通气过程中接受咪达唑仑镇静。观察两组患者在无创通气过程中的心率(HR)、平均动脉压(MAP)及呼吸频率(R)等生命体征指标的变化,及氧合指数、二氧化碳分压(PCO₂)、PH值等生理指标的变化,并比较两组谵妄、气管插管发生率及住ICU时间等差别。结果 人机无创面罩正压通气6 h后,实验组患者二氧化碳分压和心率均低于对照组,平均动脉压实验组高于对照组(P ＜0.05);氧合指数二者无明显差异(P＞0.05)。实验组住ICU时间、机械通气时间、谵妄例数、镇静过深例数和气管插管例数均小于对照组,但每日平均达镇静目标时间长于对照组。结论 右美托咪定联合布托啡诺能改善慢性阻塞性肺病患者无创呼吸机辅助呼吸过程中同步性及依从性,提高无创通气效率,安全有效。

Applied research of Dexmedetomidine Hydrochloride Injection and Butorphanol Injection in the process of non-invasive ventilation with respect to chronic obstructive pulmonary disease

Objective To investigate the effect of Dexmedetomidine Hydrochloride Injection and Butorphanol Injection in the process of non-invasive ventilation with respect to acute exacerbations of chronic obstructive pulmonary disease.Methods There were one hundred and twenty chronic obstructive pulmonary disease patients merging with respiratory failure(type II) who accepted non-invasive ventilation.They were randomly divided into two groups:the experimental group for 60 who accepted sedation and analgesia of Dexmedetomidine Hydrochloride Injection and Butorphanol Injection in the process of non-invasive ventilation and the control group for 60 who accepted sedation of midazolam in the process of non-invasive ventilation.The following indicators were observed in the process of non-invasive ventilation: vital signs indicators such as heart rate,mean arterial pressure,respiratory rate and so on,and physical signs indicators such as oxygenation index, partial pressure of carbon dioxide,PH value and so on.The differences of occurrence rate of delirium, trachea cannula and icu stay time of the two groups were compared.Results After six hours of non-invasive positive pressure,partial pressure of carbon dioxide and heart rate in the experimental group were lower than those in the control group,while mean arterial pressure in the experimental group was higher than that in the control group (P＜0.05).There was no difference in terms of oxygenation index between the two groups. ICU stay time, mechanical ventilation time, delirium case numbers and trachea cannula cases in the experimental group were less than those in the control group.While everyday average calm object time in the experimental group was more than that in the control group.Conclusion In the process of non-invasive ventilation with respect to acute exacerbations of chronic obstructive pulmonary disease patients, Dexmedetomidine Hydrochloride Injection and Butorphanol Injection can improve man-machine synchronism and compliance and noninvasive ventilation efficiency,which is safe and effective.