右美托咪定对AECOPD序贯通气患者的膈肌功能及炎性反应的影响

Dexmedetomidine on Diaphragm Function and Inflammatory Reaction in Patients with Sequential Ventilation in AECOPD

目的研究右美托咪定对AECOPD序贯通气患者膈肌功能及炎性反应的影响。方法将符合纳入标准的80例AECOPD患者随机分为A组(40例)和B组(39例,1例退出);B组在A组治疗方案基础上加用右美托咪定。在T_(1)~T_(5)时监测PCT、CRP、IL-6、TNF-α;膈肌移动度、膈肌增厚率;机械通气时间、谵妄发生率。结果T_(2)~T_(5)时,B组的CRP、PCT、IL-6、TNF-α较A组改善更优(P<0.05或P<0.01);T_(3)~T_(5)时,B组的膈肌移动度、膈肌增厚率较A组改善更优(P<0.05或P<0.01);B组的机械通气时间、谵妄发生率均少于A组(P<0.05)。结论右美托咪定可以减轻AECOPD序贯通气患者机体的炎性反应,保护膈肌功能,减少谵妄,缩短机械通气时间,患者预后较好。

Objective To study the effects of dexmedetomidine on diaphragm function and inflammatory reaction in patients with sequential ventilation in AECOPD.Methods Eighty patients with AECOPD who met the inclusion criteria were randomly divided into group A(40 patients)and group B(39 patients,1 dropout);group B added dexmedetomidine to the treatment regimen in group A.PCT,CRP,IL-6,TNF-α;diaphragm mobility,diaphragm thickening rate;duration of mechanical ventilation,delirium incidence were monitored from T_(1) to T_(5).Results From T_(2) to T_(5),CRP,PCT,IL-6,and TNF-αimproved better in group B than in group A(P<0.05 or P<0.01);from T_(3) to T_(5),diaphragm mobility and diaphragm thickening rate improved better in group B than in group A(P<0.05 or P<0.01);the duration of mechanical ventilation and the incidence of delirium were less in group B than in group A(P<0.05).Conclusion Dexmedetomidine can reduce the inflammatory response of the organism,protect the function of the diaphragm,reduce delirium,shorten the duration of mechanical ventilation in patients with sequential ventilation in AECOPD,and the patients have a better prognosis.