丙泊酚复合舒芬太尼对ICU机械通气患者预后VAS评分及呼吸抑制发生率的影响

Effects of propofol combined with sufentanil on prognostic VAS score and incidence of respiratory depression in IC.J patients with mechanical ventilation

目的 探讨丙泊酚复合舒芬太尼对重症监护室（ICU）机械通气患者预后视觉模拟评分（VAS）及呼吸抑制发生率的影响.方法 选取在ICU实施机械通气治疗的患者71例,按照随机数字袁法进行分组.对照组35例予以丙泊酚镇静镇痛,观察组36例给予丙泊酚＋舒芬太尼镇静镇痛.观察比较两组镇静效果及血流动力学各指标[心率（HR）、平均动脉压（MAP）]变化情况,并统计两组脱机后及拔管时VAS评分、镇静后恢复情况及呼吸抑制、低血压发生情况.结果 观察组镇静优良率为91.67％ （33/36）,对照组为88.57％ （31/35）,组间比较差异未见统计学意义（P＞0.05）.用药后10 min、拔管时两组HR及MAP均高于用药前,且观察组变化幅度小于对照组,差异有统计学意义（P＜0.05）.脱机后及拔管时观察组VAS评分均低于对照组,差异有统计学意义（P＜0.05）.观察组呼吸恢复、苏醒及拔管时间均少于对照组,差异有统计学意义（P＜0.05）.观察组呼吸抑制发生率为5.56％ （2/36）、低血压发生率为2.78％ （1/36）;对照组分别为2.86％（1/35）、8.57％（3/35）,组间比较差异未见统计学意义（P＞0.05）.结论 对ICU机械通气患者给予丙泊酚复合舒芬太尼干预,镇静效果佳,安全性高,可缓解患者预后疼痛度,促进镇静后机体功能恢复,且对血流动力学影响小.

Objective To investigate the effect of propofol combined with sufentanil on the prognostic visual analogue score （VAS） and the incidence of respiratory depression in patients in intensive care unit （ICU）.Methods Seventy-one patients with mechanical ventilation in ICU were divided into two groups according to the random number table method;35 patients in control group were given propofol for sedation and analgesia,36 patients in observation group were given propofol combined with sufentanil for sedation and analgesia.The sedative effect and hemodynamics indexes [heart rate （HR） and mean arterial pressure （MAP）] were observed and compared between the two groups.The VAS scores,recovery situation after sedation,respiratory depression and incidence of hypotension were observed and compared between the two groups after weaning and extubation.Results The excellent and good rate of sedation was 91.67% （33/36） in observation group and was 88.57% （31/35） in control group,there was no significant difference between the two groups （P 〉 0.05）.At 10 min after administration and at extubation,HR and MAP of the two groups were higher than those before the administration,and the changes of observation group were smaller than those of control group （P 〈 0.05）.After weaning and at extubation,the VAS of observation group was lower than that of control group （P 〈 0.05）.The respiratory recovery time,analepsis time and extubation time of observation group were shorter than those of control group （P 〈 0.05）.The incidences of respiratory depression and hypotension were 5.56% （2/36）,2.78% （1/36） in observation group,and were 2.86% （1/35）,8.57% （3/35） in control group,respectively,there was no significant difference between the two groups （P 〉 0.05）.Conclusions Propofol combined with sufentanil is effective in the treatment of ICU patients with mechanical ventilation.It has good sedative effect and high safety,which can relieve the prognostic and pain of the patients,promote the recovery of the organism function after sedation,and have little influence on the hemodynamics.