右美托咪定在支气管肺泡灌洗过程中作用的研究

目的 考察右美托咪定在未建立人工气道的颅脑疾病患者支气管肺泡灌洗过程中的作用.方法 对46例颅脑疾病后无人工气道的肺部感染患者行支气管肺泡灌洗治疗,年龄17～82岁,平均年龄（56.6±9.2）岁,其中男性26例,女性20例.随机分为2组,其中对照组23例,支气管肺泡灌洗过程中接受咪达唑仑镇静;实验组23例,支气管肺泡灌洗过程中接受右美托咪定镇静.观察2组患者在支气管肺泡灌洗前和灌洗过程中的心率、平均动脉压及指脉氧等指标的变化.结果 支气管肺泡灌洗过程中最低指脉氧实验组高于对照组,最快心率实验组低于对照组,最低平均动脉压实验组高于对照组,差异均具有统计学意义（P＜0.05）.支气管肺泡灌洗过程中与灌洗前比较,2组心率均有增快,平均动脉压下降,指脉氧下降,但实验组各指标的幅度变化较小（P＜0.05）.结论 右美托咪定对患者呼吸和血压抑制较小,用于无人工气道的颅脑疾病患者的支气管肺泡灌洗过程相对安全有效.

Effect of dexmedetomidine hydrochloride on patients in the process of bronchoalveolar lavage treatment

Objective To analyze the effect of dexmedetomidine hydrochloride injection on patients with eranioeerebral disease who has no artificial airway in the process of bronchoalveolar lavage treatment. Methods Forty-six patients （age 17-28, average age 56.6±9.2, 26 men and 20 women） with craniocerebral disease who has no artificial airway were selected, and were treated by bronchoalveolar lavage for lung infection. The patients were randomly divided into two groups, control and test group. The control group （n=23） received midazolam for sedative and the test group （n=23） received dexmedetomidine hydrochloride for sedative while they were in the process of bronchoalveolar lavage treatment. Heart rate, mean arterial pressure and blood oxygen saturation of fingers collected from patients before and during the process of bronchoalveolar lavage were compared. Results In the process of bronchoalveolar lavage treatment, the minimum blood oxygen saturation of finger artery from the control group was lower than that from the test group, the fastest heart rate from the control group was greater than that from the test group, and the lowest mean arterial pressure from the control group was lower than that from the test group （P〈0.05）. In two groups, heart rate in the process of bronchoalveolar lavage treatment was faster than that from before the treatment, while both mean arterial pressure and blood oxygen saturation of finger artery were decreased （P〈0.05）. Conclusions Continuous intravenous pumping of dexmedetomidine hydrochloride on patients with craniocerebral disease who has no artificial airway during the process of bronchoalveolar lavage treatment is effective and safe, and it has less inhibitory effect on respiratory function and blood pressure.