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目的观察丙泊酚中长链和长链脂肪乳剂在ICU急性肺损伤患者镇静治疗的比较。方法选择在ICU出现急性肺损伤需要机械通气的患者60例,将患者随机分为丙泊酚中长链脂肪乳注射液组(MCT LCT组)和丙泊酚长链脂肪乳注射液组(LCT组)各30例,分别静脉注射丙泊酚中长链脂肪乳剂和长链脂肪乳剂,剂量为0.3~4.0mg/(kg·h),镇静效果维持在Ramsay镇静评分Ⅲ~Ⅳ级,观察用药后不同时间的也率、呼吸频率、平均动脉压、氧合指数及肝功能的变化。结果两组患者用药后心率、呼吸频率较用药前下降,氧合指数有改善,两组用药后第3天谷丙转氨酶、谷草转氨酶较用药前均升高,LCT组血浆甘油三酯较用药前升高。和MCT-LCT组比较,LCT组的血浆甘油三酯和谷丙转氨酶均升高,差异有显著性。结论丙泊酚中长链脂肪乳剂和丙泊酚长链乳剂一样具有对循环影响小和改善呼吸功能及氧合的特点,丙泊酚中长链脂肪乳剂对ICU急性肺损伤需要机械通气患者的血脂及肝功能的影响较小。
Objective To compare the sedation of long-chain and long-chain fatty emulsion of propofol in patients with ICU with acute lung injury. Methods Sixty patients with acute lung injury requiring mechanical ventilation were enrolled in this study. Patients were randomly divided into propofol medium-long-fat emulsion injection group (MCT LCT group) and propofol long-chain fat emulsion injection group (LCT group Group) were given intravenous injection of propofol medium-long-chain fat emulsion and long-chain fat emulsion at a dose of 0.3-4.0 mg / (kg · h), respectively. The sedation effect was maintained at the level of Ramsay sedation Ⅲ ~ Ⅳ. After different time rates, respiratory rate, mean arterial pressure, oxygenation index and liver function changes. Results After treatment, the heart rate and respiratory rate of the two groups decreased compared with those before treatment, and the oxygenation index improved. Both alanine aminotransferase and aspartate aminotransferase increased on the 3rd day after treatment in both groups, and plasma triglyceride level in LCT group was higher than that before administration high. Compared with MCT-LCT group, plasma triglyceride and alanine aminotransferase in LCT group were significantly increased. Conclusion Propofol long-chain fat emulsion and propofol long-term emulsion have the same effect on circulation as little and improve respiratory function and oxygenation. Propofol medium long-chain fat emulsion for ICU patients with acute lung injury requiring mechanical ventilation Blood lipids and liver function less affected.