摘要
目的 研究机械通气中呼吸拮抗时应用咪唑安定和潘可罗宁对血流动力学及呼吸功能的影响。方法 将30例机械通气中发生呼吸拮抗的患者随机分成3组，组1使用潘可罗宁，组2联合使用咪唑安定和潘可罗宁，组3使用咪唑安定。分别观察3组用药前及用药后5、15、30和60min时人机协调情况，并监测血压、心率、呼吸频率及脉搏血氧饱和度（SpO2）的动态变化。结果 3组患者用药前均存在人机对抗，自主呼吸频率快SpO2下降。组2患者用药后呼吸改善最明显，人机协调一致率高，用药30min内达100％，且持续时间长；血压、心率变化小，呼吸改善及低氧血症纠正好。组1用药后5min人机协调一致率即达100％，但持续时间短；血压和心率显著升高，自主呼吸频率及低氧血症有所改善。组3人机协调一致率最低；血压、心率、呼吸频率及低氧血症均无明显变化。结论 咪唑安定和潘可罗宁合用能保持循环功能稳定，维持合适的通气功能，是一种能够合理改善机械通气中呼吸拮抗的药物治疗方法。
Objective To investigate the haemodynamic and respiratory changes following intravenous administration with midazolam, pavulon or both of them in the patients having incoordination between spontaneous breathing and mechanical ventilation. Methods Thirty patients having incoordination between spontaneous breathing and mechanical ventilation were randomly assigned to receiving intravenous injection of pavulon （group 1）, midazolam （group 3）, and both （group 2） respectively with 10 cases in each group. The degree of coordination between spontaneous breathing and mechanical ventilation, blood pressure （BP）, heart rate （HR）, respiration frequency （RF）, oxygen saturation of pulse （SpO2） were observed before the medication and at 5, 15, 30 and 60 minutes following the administration of drugs in all the patients. Results Incoordination between spontaneous breathing and mechanical ventilation, fast RF, decreased SpO2 were observed before the drug in all patients. Improvement of respiratory was significant in group 2. Patients in group 2 were in excellent coordination between spontaneous breathing and mechanical ventilation, reaching 100% within 30 minutes after administration, and lasting longer. The haemodynamics maintained stable and a significant improvement in respiration and SpO2 were found. BP and HR were elevated significantly, and RF and hypoxemia were improved, and the degree of coordination between spontaneous breathing and mechanical ventilation reached 100% 5 minutes after the drug, but with shorter duration in group 1. There were no obvious changes in BP, HR, RF and hypoxemia, and the degree of coordination between spontaneous breathing and mechanical ventilation was lowest in group 3. Conclusion The combined use of midazolam and pavulon has little influence on circulation, and it also can maintain the coordination between spontaneous breathing and mechanical ventilation. It is suggested that the combined use of midazolam and pavulon is an optimal way to improve the ventilatory function in mechanical ventilation.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2007年第2期95-97,共3页
Chinese Critical Care Medicine
