维库溴铵在重症支气管哮喘急性发作治疗中的应用

目的探讨维库溴铵在重症支气管哮喘急性发作治疗中的应用效果。方法前瞻性研究，双盲随机标准对照，将46例转入ICU使用呼吸机的重症支气管哮喘急性发作患者按病案号随机分为肌松组（予常规镇静＋维库溴铵）和常规组（予常规镇静），每组各23例，比较两组治疗效果和对预后的影响。结果肌松组病情较常规组明显改善，呼吸、pH值、PaO2、PaCO2、SpO2参数比较差异均有统计学意义（均P〈0．05）；肌松组较常规组滞留ICU时间（146．20±17．92）h与（214．15±22．21）h]，使用呼吸机时间（125．93±16．23）h与（192．89±22．60）h]，糖皮质激素（2．61±0．17）mg·kg^-1·d^-1与（3．55±0．26）mg·kg^-1·d^-1]、抗胆碱药（6．25±0．51）μg·kg^-1·d^-1与（10．64±0．75）μg·kg^-1·d^-1]、β2肾上腺素受体激动剂（0．06±0．01）mg·kg^-1·d^-1与（0．15±0．04）mg·kg^-1·d^-1]使用剂量均减少（均P〈0．05）；患者顺利转出ICU，无机械通气及心血管不良事件发生。结论维库溴铵使重症支气管哮喘急性发作患者在常规镇静使用呼吸机时，可迅速纠正临床症状，改善短期预后。

A study of vecuronium bromide on severe bronchial asthma acute attack with breathing machine in conven- tional sedati

Objective To explore the effects of vecuronium bromide within 24 hours in severe bronchial asthma with acute attack with breathing machine in conventional sedatio. Methods Prospective study, double-blind randomized standard control, where 46 cases of patients of severe bronchial asthma with acute attack transferred to ICU using breathing machine in this year were randomly divided into the vecuronium bromide group （muscle relaxant group） and conventional sedation group （normal group） according to medical record number;Two groups of sample compositiona were compared by x test, using two independent samples of t test to compare the effects the treatment and prognosis. Results After mechanical ventilation for 15min and 1-3h in muscle relaxant group, patients vital signs were statistically analyzed, including respiration ; Blood gas analysis parameters were as follows ： pH, PaO2, PaCO2 , SpO2 of these were improved compared with those in the conventional group （P 〈 0.05） with statistically significant differences;Compared with the conventional group,in the muscle relaxant group, the retention time in ICU （146.20 ± 17.92） hours, （214.15 ± 22.21 ） hours, the using time of breathing machine （ 125.93 ±16.23） hours, （ 192.89 ±22. 60）hours,and the dosage of glucocorticoid（2.61±0.17）mg ·kg^-1·d^-1, （3.55 ±0.26）mg · kg^-1 · d^-1 ,anti- cholinergic agent（6.25 ±0.51 ） μg · kg^-1 d^-1 , （ 10.64 ±0.75） μg ·kg^-1· d^-1 and 132 adrenergic receptor agonist （0.06 ±0.01）mg · kg^-1 · d^-1 , （0.15 ±0. 04）mg· kg^-1 · d^-1 were all reduced （all P 〈0.05） with statistically significant differences ;The patients were smoothly transferred out of ICU, without the adverse events of mechanical ventilation and cardiovascular diseases. Conclusion The use of vecuronium bromide made the patients with severe bronchial asthma in routine sedation use of breathing machine rapidly correct the clinical symptoms and improve the off-period prognosis.