【摘要】 目的:探讨每日唤醒对ICU慢性阻塞性肺疾病行机械通气患者的影响。方法:选择140病例,随机分为唤醒组和对照组,两组均给予丙泊酚镇静和芬太尼持续静脉泵入镇痛。唤醒组机械通气满24 h后实施每日唤醒两次。比较两组患者呼吸循环指标、炎症指标和相关生化指标变化以及停用镇静药物后完全清醒时间、拔管脱机时间和患者各种管路自行拔除的发生率等。结果:唤醒组二氧化碳分压(PCO2)、血糖、甘油三酯值等显著低于对照组(P<0.05);治疗后唤醒组白细胞,PCT,TNF-α,IL-6均较对照组低(P<0.05);唤醒组停用镇静药物后完全清醒时间、机械通气时间,肺不张的发生率均显著低于对照组(P<0.05)。结论:ICU慢性阻塞性肺疾病机械通气患者实施每日唤醒缩短机械通气时间,不良反应低,经济适用。更多还原

【Abstract】 Objective To explore the effects of daily interruption of sedation on patients with chronic obstructive pulmonary disease(COPD) undergoing mechanical ventilation in ICU.Methods 140 COPD patients undergoing mechanical ventilation were randomly assigned into two groups.All the patientse received propofol and fentanyl.The patients in interruption group received interruption of sedation twice daily 24 hours after mechanical ventilation.Indexes of hemodynamics,blood gas and inflammatory factors,biochemical indices,full recovery time,extubation time,and incidence of agitation were recorded.Results Vital signs were more stable in the control group(P < 0.05).RR amd PO2 were higher while PCO2,blood glucose,and triglyceride(TG) were lower in interruption group than in the control group(P < 0.05).Interruption group had lower Inflammatory factor levels(P < 0.05).Full recovery time,time to mechanical ventilation,and incidence of atelectasis were also lower in interruption group(P < 0.05).Conclusions Daily interruption of sedation can shorten time to mechanical ventilation and causes fewer adverse reactions in COPD patients undergoing mechanical ventilation in ICU.更多还原