右美托咪定在慢阻肺呼吸衰竭患者无创通气中应用的临床观察(2)
本研究中应用右美托咪定对AECOPD合并呼吸衰竭 NPPV患者镇静获得良好效果, 能明显延长NPPV的带机时间, 提高依从性, 从而发挥NPPV的治疗作用, 使得动脉血气指标明显好转, 降低了气管插管率。文献报道[6]右美托咪定在使用过程中可以发生心排血量下降, 心率减慢, 多发生在短时间给予负荷剂量及血容量不足的患者。本研究中, 右美托咪定以持续静脉泵注的方式给药, 剔除了血容量不足、血压过低、心动过缓的患者, 避免静脉推注负荷剂量, 未发生显著心动过缓和低血压, 临床使用安全性高。
参考文献
[1]中华医学会重症医学分会.慢性阻塞性肺疾病急性加重患者的机械通气指南(2007).中华急诊医学杂志, 2007(4):350-357.
[2]Delclaux C, L'Her E, Alberti C, et al. Treatment of acute hypox-emic nonhypercapnic respiratory insufficiency with continuous posi-tive airway pressure delivered by a face mask: A randomized con-trolled trial. JAMA, 2000, 284(18):2352-2360.
[3]Carlucci A, Richard JC, Wysocki M, et al. Noninvasive versus conventional mechanical ventilation. An epidemiologic survey. Am J Respir Crit Care Med, 2001, 163(4):874-880.
[4]石佳, 于钦军. 右美托咪定的药理作用及在重症监护病房中的应用. 国际麻醉学与复苏杂志, 2007, 28(6):540-542.
[5]Akada S, Takeda S, Yoshida Y, et al. The efficacy of dexmedetomi-dine in patients with noninvasive ventilation: a preliminary study. Anesth Analg, 2008, 107(1):167-170.
[6]陆洋, 沈浩亮, 王林华, 等.右美托咪定用于无创机械通气镇静30例.医药导报, 2012(12):1573-1577.
[收稿日期:2015-05-22], 百拇医药(牟照红?赵娟?许辉)
参考文献
[1]中华医学会重症医学分会.慢性阻塞性肺疾病急性加重患者的机械通气指南(2007).中华急诊医学杂志, 2007(4):350-357.
[2]Delclaux C, L'Her E, Alberti C, et al. Treatment of acute hypox-emic nonhypercapnic respiratory insufficiency with continuous posi-tive airway pressure delivered by a face mask: A randomized con-trolled trial. JAMA, 2000, 284(18):2352-2360.
[3]Carlucci A, Richard JC, Wysocki M, et al. Noninvasive versus conventional mechanical ventilation. An epidemiologic survey. Am J Respir Crit Care Med, 2001, 163(4):874-880.
[4]石佳, 于钦军. 右美托咪定的药理作用及在重症监护病房中的应用. 国际麻醉学与复苏杂志, 2007, 28(6):540-542.
[5]Akada S, Takeda S, Yoshida Y, et al. The efficacy of dexmedetomi-dine in patients with noninvasive ventilation: a preliminary study. Anesth Analg, 2008, 107(1):167-170.
[6]陆洋, 沈浩亮, 王林华, 等.右美托咪定用于无创机械通气镇静30例.医药导报, 2012(12):1573-1577.
[收稿日期:2015-05-22], 百拇医药(牟照红?赵娟?许辉)