不同负荷剂量的右美托咪定对ICU高龄患者血循环和血氧含量及血乳酸的影响

Effects of Different Loading Doses of Dexmedetomidine on Blood Circulation,Blood Oxygen Content and Blood Lactic Acid in Elderly Patients in ICU

目的研究不同负荷剂量的右美托咪定对ICU高龄患者血氧含量和血乳酸的影响。方法2019年1月—2020年1月该院ICU收治的高龄患者,90例研究对象给予3种不同负荷剂量的右美托咪定,进入A组(0.5μg/kg负荷10 min)、B组(0.7μg/kg负荷10 min)和C组[(1.0μg/(kg·h)维持1 h)]3组,之后3组0.4μg/(kg·h)静脉注射维持到2 h。监测无创平均动脉压和心率,通过检测用药前后动脉、中心静脉血气分析结果,获取血乳酸水平并进一步计算血氧含量。结果平均动脉压A组用药后2 h与用药前相比差异无统计学意义(t=0.213,P﹥0.05),B组和C组差异有统计学意义(t=0.010、0.001,P<0.05)。3组心率用药前后均差异有统计学意义(t=0.005、0.026、0.011,P<0.05)。但平均动脉压和心率用药前后差值3组之间差异无统计学意义(P>0.05)。动脉和中心静脉血氧含量用药前后3组均差异无统计学意义(P>0.05),且3组动脉与中心静脉血氧含量差值用药前后均差异无统计学意义(P﹥0.05),及动脉与中心静脉血氧含量差值3组间比较均差异无统计学意义(P﹥0.05)。动脉和静脉血乳酸用药前后差异无统计学意义(P>0.05),且动脉和静脉血乳酸用药前后差值3组间的比较均差异无统计学意义(P﹥0.05)。结论ICU高龄患者在负荷剂量不超过0.7μg/kg情况下,右美托咪定虽然会引起心率和平均动脉压的下降,但对血氧含量和血乳酸水平没有影响。

Objective To study the effects of different loading doses of dexmedetomidine on blood oxygen content and blood lactate in elderly patients in ICU.Methods 90 research subjects were treated with dexmedetomidine at three different loading doses of elderly patients admitted to the ICU of the hospital from January 2019 to January 2020,and entered group A(0.5μg/kg load for 10 min)and group B(0.7μg/kg load for 10 min)and C group[(1.0μg/(kg·h)for 1 h)],and then the three groups 0.4μg/(kg·h)intravenous injection for 2 h.Monitor the non-invasive mean arterial pressure and heart rate,and obtain the blood lactic acid level and further calculate the blood oxygen content by detecting the results of the arterial and central venous blood gas analysis before and after the medication.Results There was no statistically significant difference in mean arterial pressure in group A 2 h after medication and before medication(t=0.213,P>0.05),and the difference between group B and group C was statistically significant(t=0.010,0.001,P<0.05).There were statistically significant differences in the heart rate of the three groups before and after medication(t=0.005,0.026,0.011,P<0.05).However,the difference in mean arterial pressure and heart rate before and after medication was not statistically significant between the three groups(P>0.05).Arterial and central venous blood oxygen levels were not statistically significantly different before and after treatment in the three groups(P>0.05),and the difference between arterial and central venous blood oxygen levels in the three groups was not statistically significant before and after treatment(P>0.05),and There was no statistically significant difference in the difference between arterial and central venous blood oxygen content among the three groups(P>0.05).The difference between arterial and venous blood lactic acid before and after medication was not statistically significant(P>0.05),and there was no statistically significant difference between the three groups in the difference of arterial and venous blood lactic acid before and after medication(P>0.05).Conclusion When the loading dose of ICU elderly patients does not exceed 0.7μg/kg,although dexmedetomidine can cause a decrease in heart rate and mean arterial pressure,it has no effect on blood oxygen content and blood lactate level.