感染、炎症、修复
感染、炎癥、脩複
감염、염증、수복
INFECTION， INFLAMMATION， REPAIR
2014年
4期
229-231
,共3页
右美托咪啶%纤维支气管镜%血压%心电图
右美託咪啶%纖維支氣管鏡%血壓%心電圖
우미탁미정%섬유지기관경%혈압%심전도
Dexmedetomidine%Bronchoscopy%Blood pressure%Electrocadiogram
目的：：观察右美托咪定对重症患者行纤维支气管镜(纤支镜)检查时心率、平均动脉压和心电图的影响。方法：选择2013年5月—2014年5月住入 ICU需要行纤支镜检查的患者50例,随机分成右美托咪啶组和对照组。右美托咪啶组在行纤支镜检查前15 min给予2%利多卡因10 ml 雾化吸入,并静脉泵入右美托咪啶负荷量1μg/kg,10 min匀速泵入,随后以0.2~0.4μg·kg-1·h-1的速度持续泵入,达到镇静程度为Ramsay评分4级,直至纤支镜检查结束。对照组仅行2%利多卡因10 ml雾化吸入。观察两组患者检查开始前和检查结束时的心率、平均动脉压以及心电图 ST-T段变化。结果：与纤支镜检查前比较,对照组患者在纤支镜检查结束时心率明显加快、平均动脉压明显升高,且与右美托咪啶组检查结束时比较差异有显著性(P<0.05)。右美托咪啶组纤支镜检查后心率、血压轻度升高,但与检查前比较差异无显著性(P>0.05)。右美托咪啶组 ST-T 下移或抬高大于0.05 mV的患者仅5例,而对照组为15例,两组比较差异有统计学意义(P<0.05)。结论：危重患者在行纤支镜检查时给予右美托咪啶适当镇静可以稳定患者的循环系统,保护心肌。
目的：：觀察右美託咪定對重癥患者行纖維支氣管鏡(纖支鏡)檢查時心率、平均動脈壓和心電圖的影響。方法：選擇2013年5月—2014年5月住入 ICU需要行纖支鏡檢查的患者50例,隨機分成右美託咪啶組和對照組。右美託咪啶組在行纖支鏡檢查前15 min給予2%利多卡因10 ml 霧化吸入,併靜脈泵入右美託咪啶負荷量1μg/kg,10 min勻速泵入,隨後以0.2~0.4μg·kg-1·h-1的速度持續泵入,達到鎮靜程度為Ramsay評分4級,直至纖支鏡檢查結束。對照組僅行2%利多卡因10 ml霧化吸入。觀察兩組患者檢查開始前和檢查結束時的心率、平均動脈壓以及心電圖 ST-T段變化。結果：與纖支鏡檢查前比較,對照組患者在纖支鏡檢查結束時心率明顯加快、平均動脈壓明顯升高,且與右美託咪啶組檢查結束時比較差異有顯著性(P<0.05)。右美託咪啶組纖支鏡檢查後心率、血壓輕度升高,但與檢查前比較差異無顯著性(P>0.05)。右美託咪啶組 ST-T 下移或抬高大于0.05 mV的患者僅5例,而對照組為15例,兩組比較差異有統計學意義(P<0.05)。結論：危重患者在行纖支鏡檢查時給予右美託咪啶適噹鎮靜可以穩定患者的循環繫統,保護心肌。
목적：：관찰우미탁미정대중증환자행섬유지기관경(섬지경)검사시심솔、평균동맥압화심전도적영향。방법：선택2013년5월—2014년5월주입 ICU수요행섬지경검사적환자50례,수궤분성우미탁미정조화대조조。우미탁미정조재행섬지경검사전15 min급여2%리다잡인10 ml 무화흡입,병정맥빙입우미탁미정부하량1μg/kg,10 min균속빙입,수후이0.2~0.4μg·kg-1·h-1적속도지속빙입,체도진정정도위Ramsay평분4급,직지섬지경검사결속。대조조부행2%리다잡인10 ml무화흡입。관찰량조환자검사개시전화검사결속시적심솔、평균동맥압이급심전도 ST-T단변화。결과：여섬지경검사전비교,대조조환자재섬지경검사결속시심솔명현가쾌、평균동맥압명현승고,차여우미탁미정조검사결속시비교차이유현저성(P<0.05)。우미탁미정조섬지경검사후심솔、혈압경도승고,단여검사전비교차이무현저성(P>0.05)。우미탁미정조 ST-T 하이혹태고대우0.05 mV적환자부5례,이대조조위15례,량조비교차이유통계학의의(P<0.05)。결론：위중환자재행섬지경검사시급여우미탁미정괄당진정가이은정환자적순배계통,보호심기。
Objective:To observe the effect of dexmedetomidine on heart rate,mean arterial pressure and electro-cardiogram (ECG)in critically ill patients during fiberoptic bronchoscopy. Methods:Fifty patients,admitted to ICU from May 2013 to May 2014 and undergoing fiberoptic bronchoscopy,were randomly divided into two groups:control group(n=25)and dexmedetomidine group (n=25). In patients of dexmedetomidine group,aero-sol inhalation of 2% idocaine 10 ml was given 15 minutes before bronchoscopy,and a loading dose of dexmedeto-midine 1μg/kg was injected intravenously within 10 minutes before bronchoscopy,followed by intravenous infu-sion of 0.2-0.4μg·kg-1 ·h-1 until the end of bronchoscopy. In the control group,patients only received aero-sol inhalation of 2% idocaine 10 ml. The heart rate,mean arterial pressure and changes in ST-T of ECG before and after bronchoscopy were observed.Results:In patients of the control group,a significant increase in heart rate and mean arterial pressure were observed(P<0.05),while in the dexmedetomidine group,the patient’s heart rate and mean arterial pressure increased only slightly after bronchoscopy(P>0.05),and the difference was not signif-icant compared to those before bronchoscopy(P>0.05). Changes in ST-T of ECG was higher than 5 mV in 5 ca-ses of the dexmedetomidine group,but it was observed in 1 5 cases in the control group,the difference was signifi-cant(P<0.05). Conclusions:For critically ill patients with bronchoscopy,administration of dexmedetomidine can stabilize the patient's circulatory system and protect myocardium against stress.
