慢性阻塞性肺疾病急性发作无创通气治疗中应用右美托咪定的临床研究

Clinical study for dexmedetomidine during noninvasive ventilation for patients with acute exacerbation ofchronic obstructive pulmonary disease

目的观察右美托咪定在慢性阻塞性肺疾病急性发作（acute exacerbation of chronicobstructive pulmonary disease,AECOPD）无创通气 （noninvasive ventilation, NIV）患者中的镇静作用的有效性和安全性，探讨其是否可改善此类患者临床结局。方法选取我科收治的61例AECOPD符合NIV指征的患者随机分为2。组，2组都给予常规治疗加NIV治疗，治疗组在此基础上加用右美托咪定，比较2组患者对NIV的依从性以及治疗效果。结果2组患者治疗后心率、平均动脉压、呼吸频率、动脉血气均较治疗前明显改善（P值均〈0．05），治疗组治疗后上述指标较对照组改善更明显（P值均〈0．05）。治疗组对NIV的依从性明显优于对照组。结论对于AECOPD患者NIV治疗加用右美托咪定镇静安全有效，值得临床推广应用。

Objective To investigate the efficacy and safety of sedation with dexmedetomidine for patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） during the treatment of noninvasive ventilation （NIV） and explone whether or not to improve clinical outcomes. Methods Total of 61 patients with AECOPD were collected from intensive care unit in our hospital. The patients were divided into two groups randomly. They were treated by common treatment and NIV in both two groups,and dexmedetomidine was introduced to sedate in the treatment group. The compliance of the therapy and the ultimate effects were compared. Results After therapy, the cardiorespiratory symptoms and signs （heart rate, mean blood pressure, respiratory rate and arterial blood gas analysis） were significantly improved in both groups （all P 〈 0.05）, but the treatment group were proved of better compliance and better therapeutic effects（all P 〈0.05）. Conclusions The dexmedetomidine is safe and effective for patients with AECOPD during the treatment of NIV.