右美托咪啶复合布托啡诺对ICU中AECOPD使用有创机械通气患者临床疗效及血气分析指标的分析

Effect of dexmedetomidine combined with butorphanol on clinical efficacy and blood gas analysis of patients with invasive mechanical ventilation using AECOPD in ICU

目的探讨右美托咪啶复合布托啡诺对重症监护室(ICU)中慢性阻塞性肺疾病急性加重期(AECOPD)使用有创机械通气患者临床疗效及血气指标的影响。方法选取2016年7月~2017年6月本院ICU病房收治的AECOPD患者50例,按随机数字表法分为两组,对照组25例,给予咪达唑仑复合布托啡诺治疗,观察组25例,给予右美托咪啶复合布托啡诺治疗,观察两组用药前、用药后1 h、用药后6 h、用药后12 h心率、血压、呼吸频率等指标变化,比较两组布托啡诺用量、有效镇痛时间、停药后唤醒时间及不良反应发生情况。结果两组用药后1 h、6 h、12 h心率、收缩压、舒张压、呼吸频率较用药前均有所降低,但观察组上述指标下降幅度低于对照组(P<0.05);观察组布托啡诺用量低于对照组,有效镇痛时间及停药后唤醒时间短于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论对AECOPD机械通气患者右美托咪啶复合布托啡诺镇静方案可取得良好效果,维持血流动力学稳定,且减少布托啡诺用量,降低不良反应发生率。

Objective To investigate the effect of dexmedetomidine combined with butorphanol on blood gas indexes in patients with invasive mechanical ventilation during acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in intensive care unit(ICU).Methods 50 AECOPD were selected from July 2016 to June 2017 in our hospital ICU ward were randomly divided into 2 groups,25 cases in control group were given midazolam combined Bhutto butorphanol treatment,25 cases in the observation group were given dexmedetomidine combined with butorphanol Bhutto treatment,observation of two groups before treatment.1 h after administration,6 h after administration,12 h after administration of heart rate,blood pressure,respiration frequency and other indicators,compared with two groups of Bhutto butorphanol dosage,effective analgesia time,wake up after discontinuation of the occurrence of adverse reactions.Results The heart rate,systolic blood pressure,diastolic blood pressure and respiratory rate at 1 h,6 h,12 h after treatment were lower than those before treatment,but the decrease of the above indexes in the observation group was lower than that in the control group(P<0.05).The dosage of morphine was lower than that of the control group,the effective analgesia time and wake-up time after discontinuation were shorter than those of the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that of the control group(P<0.05).Conclusion Dexmedetomidine combined with butorphanol sedation in patients with AECOPD mechanical ventilation can achieve good results in hemodynamic stability and reduce the dosage of butorphanol,and reduce the incidence of adverse reactions.