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目的:探讨丙泊酚对精神病患者机械通气治疗急性左心功能衰竭时的镇静效果。方法:将急性左心衰住院精神病患者38例随机分成度冷丁组(n=20)和丙泊酚组(n--18),机械通气治疗期分别间断静脉注射度冷丁50-100 mg及持续静滴丙泊酚(0.5-1.0)mg/(kg·h);比较两组镇静效果达Ramsay分级Ⅲ-Ⅳ级时间、生命体征、循环参数的变化。结果:治疗后1 h,两组血流动力学指标均较治疗前有显著改善;与度冷丁组相比,丙泊酚组的心脏指数(CI)显著升高,肺动脉压(PAP)、肺毛细血管楔压(PCWP)和外周血管阻力(SVR)明显下降,P均<0.05,心率(HR)、中心静脉压(CVP)无明显差别,P>0.05。结论:精神病患者机械通气治疗急性左心衰时使用丙泊酚镇静效果较度冷丁好。
Objective: To investigate the sedation effect of propofol on patients with mental illness during mechanical ventilation for acute left heart failure. Methods: Thirty - eight patients with psychosis of acute left heart failure were randomly divided into two groups: n = 20 and n = 18. Patients in the period of mechanical ventilation were given intermittent intravenous injection of meperidine 50-100 mg for the duration of mechanical ventilation. Intravenous infusion of propofol (0.5-1.0) mg / (kg · h); comparison of sedation effect of two groups of Ramsay grading Ⅲ-Ⅳ grade time, changes in vital signs, circulatory parameters. Results: At 1 hour after treatment, the hemodynamic indexes of both groups were significantly improved compared with those before treatment. Compared with the chilling group, the cardiac index (CI) of propofol group was significantly increased. The pulmonary arterial pressure (PAP), pulmonary Capillary wedge pressure (PCWP) and peripheral vascular resistance (SVR) were significantly decreased, P <0.05, heart rate (HR), central venous pressure (CVP) no significant difference, P> 0.05. CONCLUSIONS: Mental retardation is better with propofol when patients with mental illness have mechanical ventilation for acute left heart failure.