镇静对机械通气患者呼吸功能的影响

Effect of sedation on respiratory function of patients undergoing mechanical ventilation

镇痛镇静是重症加强治疗病房（ICU）机械通气患者的重要治疗手段,可使患者舒适安全地接受机械通气治疗,从而改善人机对抗,减少呼吸机相关性肺损伤（VILI）,提高治疗依从性,降低氧耗和减少应激,防止意外事件发生,降低危重患者的并发症发生率及病死率.虽然镇静治疗可以保护患者肺功能,但同时对呼吸功能的影响也较大.基于国内外对机械通气患者镇静治疗的相关研究成果,本文主要从镇静治疗、不同镇静药物及不同镇静方案对机械通气患者呼吸功能的影响3个方面进行研究和阐述,探讨镇静治疗改善人机协调性、保护肺功能等作用及同时存在的自主呼吸功能抑制、延迟拔管等问题,为机械通气患者的镇静治疗提供参考依据.

Sedation and analgesia for ventilated patients is an important treatment in intensive care unit （ICU）. Patients receiving mechanical ventilation therapy comfortably and safely can improve patient-ventilator synchrony, reduce ventilation-related lung injury （VILI）, improve compliance, decrease oxygen consumption and stress, prevent accidents, and reduce the incidence of complications and mortality in critical patients. Although sedation mayprotect lung function, it also has a greater impact on respiratory function. Therefore, based on domestic and overseas related researches about sedation therapy in ventilated patients, we expounded on the effects of sedation therapy, different sedatives and different sedative methods on respiratory function of ventilated patients. The effects of sedation improving patient-ventilator synchrony or protecting pulmonary function as well as problems about inhibition of spontaneous respiration or delayed extubation were discussed to provide references for sedation treatment in patients with mechanical ventilation.