丙泊酚对ICU患者呼吸力学和氧代谢的影响

目的观察丙泊酚在ICU患者镇静中对肺静态顺应性(Cst)、气道阻力(R)以及氧摄取率(ERO2)、肺内分流(Qs/Qt)和氧合指数的影响。方法 30例行机械通气需要镇静的患者随机分成两组,每组15例。观察组镇静用丙泊酚,对照组用咪唑安定。观察两组患者镇静后的Cst、R、ERO2、Qs/Qt、氧合指数的变化。结果镇静后观察组与对照组比较,肺静态顺应性、肺内分流、氧合指数无显著差别,气道阻力和氧摄取率较对照组显著降低。结论丙泊酚对肺静态总顺应性无明显影响,对改善患者氧合指数也无明显优势,但能显著降低机械通气患者的气道阻力,降低组织氧摄取率,不增加肺内分流。

Effect of Propofol on Respiratory Mechanic Dynamics and Aerobic Metabolism in Patients in ICU

Objective To observe the effect of propofol on pulmonary static compliance,airway resistance,oxygen uptaking rate,pulmonary shunt fraction and oxygenation indexes in sedation in ICU patients.Methods Thirty cases were randomly divided into two groups： observation group and control group.Propofol was used for the observation group,and midazolan was used for the control group.The changes of Cst,R,ERO2,Qs/Qt and oxygenation indexes were observed during sedation.Results There was a significant decrease in airway resistance（P0.01） and oxygen uptaking rate（P0.05）,but no significantly difference in pulmonary static compliance,pulmonary shunt fraction and oxygenation indexes between the two groups.Conculsion Of pulmonary static tabor phenol total compliance with no significant effect to improve patients with oxygen,also do not have apparent advantages fits the index,but could significantly reduce mechanical ventilation of airway resistance and reduce patients tissue oxygen uptake rate and increase in lung bypass.