丙泊酚对ARDS患者血液动力学及氧合的影响

目的观察丙泊酚对急性呼吸窘迫综合征(ARDS)患者进行治疗时血液动力学的反应和肺部氧合的影响,分析丙泊酚的治疗效果如何。方法将本院2009年8月²013年8月期间收治的60例实施机械通气的ARDS患者作为研究对象,随机分为研究组(A组)和对照组(B组)各30例。研究组采取镇静诱导和丙泊酚维持治疗法,对照组则采用镇静诱导和咪唑安定维持治疗法。视患者情况调整患者用药量,具体可参照Ramsay分级标准。分别记录两组患者镇静诱导前1、6、10、14 h时的血液动力学变化;此外需在测定血液动力学的同一时间时采集患者中心静脉血和股动脉血以测定血气,随后计算患者的肺内动静脉分流率和氧合指数,整理分析进行比较。结果经治疗的12013年8月期间收治的60例实施机械通气的ARDS患者作为研究对象,随机分为研究组(A组)和对照组(B组)各30例。研究组采取镇静诱导和丙泊酚维持治疗法,对照组则采用镇静诱导和咪唑安定维持治疗法。视患者情况调整患者用药量,具体可参照Ramsay分级标准。分别记录两组患者镇静诱导前1、6、10、14 h时的血液动力学变化;此外需在测定血液动力学的同一时间时采集患者中心静脉血和股动脉血以测定血气,随后计算患者的肺内动静脉分流率和氧合指数,整理分析进行比较。结果经治疗的1¹4 h后,两组患者较镇静诱导前的MAP和HR值有着明显下降,其差异有显著性,具统计学意义(p<0.05)。研究组和对照组比较在614 h后,两组患者较镇静诱导前的MAP和HR值有着明显下降,其差异有显著性,具统计学意义(p<0.05)。研究组和对照组比较在6¹4 h时,研究组的肺内动静脉分流率下降、氧合指数升高,其差异有显著性,具统计学意义(p<0.05)。结论丙泊酚镇静剂可有效提高ARDS患者的氧合指数,疗效确切,可在临床上安全使用。

INFLUENCE OF PROPOFOL ON HEMODYNAMIC AND OXYGENATION IN PATIENTS WITH ARDS

Objective To observe the hemodynamic therapeutic response and lung oxygenation of patients with acute respiratory distress syndrome （ ARDS ） in propofol treatment analyzing the curative effect of propofol. Methods 60 patients with acute respiratory distress syndrome admitted by our hospital from August 2009 to August 2013 were enrolled as research subjects. They were randomly divided into study group （A） and control group （group B） each 30 cases . Study group was given propofol sedation induction and maintenance treatment method, the control group using midazolam sedation induction and maintenance therapy method. Depending on the patient＇s condition dos- age adjustment were made with specific reference to Ramsay grading standards. Hemodynamic changes were recorded before the two groups of patients＇ sedation induction , 1 h, 6h, 10h, 14h time; it was demanded to collect the patient＇ s central venous and femoral arterial blood at the same time of hemodynamic measurement to make blood gas analysis, and then calculate the patients＇ pulmonary arteriovenous shunt rate and oxygenation index , sorting the data to com- pare. Results After treatment 1 ~ 14 h, the MAP and HR values of the two groups were decreased comparing with before induction of sedation, the difference werestatistically significant （p 〈 0.05 ）. At 6 - 14 h, comparing with the control group, the pulmonary arteriovenous shunt rate of study group decreased, and its oxygenation index increased, the difference were statistically significant （p 〈 0. 05 ）. Conclusion Propofol sedation can effectively improve the oxygenation index of patients with acute respiratory distress syndrome, it is effective and safe to use in clinical practice.