3种镇静药物对Ⅱ型呼吸衰竭机械通气的影响

Comparison of Sedative Effect of Morphine,Diazepam and Midazolam on Patients during Mechanical Ventilation with Type Ⅱ Respiratory Failure

目的:对比观察吗啡、地西泮与咪达唑仑镇静对Ⅱ型呼吸衰竭患者机械通气治疗效果的影响,以期对临床用药的选择提供参考。方法:将54例需机械通气的Ⅱ型呼吸衰竭患者随机分为3组,每组18例。分别于机械通气前静注吗啡、地西泮与咪达唑仑镇静,再于机械通气前和机械通气后4 h行动脉血气分析。结果:与机械通气前比较各组pH值、PaO2值和PaCO2值均得到明显改善(P<0.01)。机械通气后吗啡组pH与PaO2值大于地西泮和咪达唑仑组,PaCO2值则较另外2组小(P<0.05);地西泮组与咪达唑仑组之间各指标均无显著性差异(P>0.05)。结论:相对于地西泮与咪达唑仑,吗啡能够使需机械通气的Ⅱ型呼吸衰竭患者更多获益,可以成为该类病人镇静的首选用药。

Objective：To evaluate the effect of morphine,diazepam and midazolam on patients during mechanical ventilation with type Ⅱ respiratory failure.Methods：Fifty-four patients were randomized into three groups.Every group haven eighteen cases.Morphine,diazepam and midazolam were injected intravenously as sedative induction in each group.Four hours after mechanical ventilation,arterial blood gas parameter was performed in all cases.Results：（1） Compared with counterpart,the increase of PH,PaO2 and the decrease of PaCO2 in the after mechanical ventilation groups were significant in all of them（P〈0.01）.（2） Compared with intergroups,There were no significant difference of pH,PaO2 and PaCO2 between diazepam group and midazolam group（P〈0.05）,but was significant among morphine group more than others（P〈0.05）.Conclusion：Patients during mechanical ventilation with type Ⅱ respiratory failure will gain more profit from morphine than diazepam and midazolam.Morphine should be selected preferentially in this situation.