【摘要】 目的:探讨以靶控制输注(TCI)异丙酚在ICU危重病人中的应用。方法:将120例入住我科ICU病房,APACHEⅡ评分≥16分的患者随机分为对照组和试验组。对照组(A组)使用咪达唑仑(Midazolam)+芬太尼(Fendanyl)进行镇静、镇痛治疗;试验组(B、C组),其中B组使用异丙酚(Propofol)+芬太尼按传统方法进行镇静、镇痛治疗;C组使用TCI泵输注异丙酚+芬太尼进行镇静、镇痛治疗。使患者Ramsay评分控制在(2～5)分。各组分别在用药前、用药后12、24小时记录心率(HR)、平均动脉压(MAP)。结果:A组病人24小时内,患者MAP和HR与治疗前相比差异无显著性(P>0.05);B组患者24小时内,病人MAP和HR与治疗前相比即出现下降,结果有统计学差异(P<0.05);C组病人4小时内,病人MAP和HR与治疗前相比未出现明显变化(P>0.05)。结论:使用TCI技术输注进行镇静治疗与传统恒速输注方法相比,在提供更为稳定的血药浓度,提高镇静的可控性与灵活性的同时,能有效避免其对心血管系统的抑制作用。更多还原

【Abstract】 Objective:To study the sedation effect of target controlled infusion with Propofol on Severe Patients in Intensive Care Unit. Methods:120 patients underwent the acute physiology and chronic health evaluation (APACHE),with APACHE Ⅱ≥16,were randomly divided into three groups:Group A was contrasting group,use Midoxolam and Fentanyl for pain controlling and sedation with micro pump infusion system;Group B was the group of Propofol and Fentanyl with micro pump infusion system;Group C was the group of Propofol and Fentanyl with target controlled infusion(TCI),controlling the Patients’ Ramsay Score between 2 to 5.HR and MAP were monitored before infusion, 12hours after infusion and 24 hours after infusion were measured each time.Results:MAP and HR have no significant difference before and after infusion in group A(in 24 hours);MAP and HR were decreased and have significant difference before and after infusion in group B(P>0.05);MAP and HR have no significant difference before and after infusion in group C(in 24 hours)(P>0.05).Conclusion:Compared to the traditional continuing infusion methods,TCI technique can provide more stable blood concentration,increase the agility and controllability of sedation and effectively avoid the suppression of the cardiovascular system.更多还原