咪唑安定用于慢性阻塞性肺部疾病患者机械通气时的效果观察

Effect of Midazolam on COPD Patients with Mechanical Ventilation

目的观察咪唑安定用于慢性阻塞性肺部疾病(COPD)患者机械通气时改善人机对抗的临床效果。方法对56例机械通气时发生人机对抗COPD患者应用咪唑安定治疗,观察用药前和用药后1、4、12h时患者的呼吸(RR)、心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)、酸碱度(pH)、二氧化碳分压(PCO2)、氧分压(PO2)的变化和评估镇静效果。结果咪唑安定应用于COPD患者机械通气改善人机对抗,82.14%患者的Ramsay镇静评分达2～4分,用药后患者RR、HR、MAP、SpO2、pH、PCO2、PO2均有明显改善(P<0.05,P<0.01),但对血压有一定影响。结论咪唑安定对机械通气中的人机对抗疗效好,患者的通气状况可明显改善,但应加强对循环的监测和管理。

OBJECTIVE：To observe the clinical efficacy of midazolam on relieving resistance between patients with COPD （chronic obstructive pulmonary disease） undergoing mechanical ventilation and ventilators .METHODS： 56 COPD patients undergoing mechanical ventilation were administered with midazolam, with respiration rate（RR）, heart rate, mean arterial pressure（MAP）, pulse oxygen saturation（SpO2）, power of hydrogen（pH）, partial pressure of carbon dioxide（PCO2）, partial pressure of oxygen（PO2） observed before medication and at 1, 4, 12 hours after medication, and the sedation effect evaluated. RESULTS： Midazolam improved the resistance between COPD patients undergoing mechanical ventilation and ventilators, with 82.14% of the patients achieved Ramsay score of 2 to 4,it also significantly improved RR,HR,MAP,SpO2,pH,PCO2 and PO2 （P 〈 0.05, P〈 0.01）, but had a slight impact on blood pressure .CONCLUSION ： Midazolam has a satisfactory effect on relieving the resistance between COPD patients undergoing mechanical ventilation and ventilators, and it can improve patients＇ ventilation condition, but the monitoring of blood circulation should be emphasized.