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目的:研究丙泊酚对机械通气在治疗外科术后重度Ⅱ型呼吸衰竭的血气分析、气道阻力以及肺功能等影响。方法:将44例外科术后重度Ⅱ型呼吸衰竭的患者随机分为两组(每组各22例),对照组:咪唑安定静脉注射10～20 mg;丙泊酚组:丙泊酚静脉注射泵持续输注0.5～2.0 mg/(kg.h),比较治疗1/2、1 h后,两组动脉血气分析中的pH、PaO2、PaCO2变化,Pmax、Ppalt以及肺功能中PEF、FEV1/FVC的变化。结果:与对照组比较,丙泊酚组在治疗后PaCO2显著降低,pH在治疗后1/2 h回到正常范围内,恢复较迅速(P<0.05～0.01);治疗后1/2 h的PaO2、PaO2/Fi O2也比对照组有显著升高。丙泊酚组在治疗后的Pmax、Ppalt较对照组有明显下降,PEF、FEV1/FVC的提高较对照组显著(P<0.05～0.01)。结论:丙泊酚进行镇静在外科术后重度Ⅱ型呼吸衰竭治疗中可降低气道阻力,改善氧合功能,减少人机对抗。
Objective: To study the effect of propofol on the blood gas analysis, airway resistance and lung function of mechanical ventilation in the treatment of severe type Ⅱ respiratory failure after surgery. Methods: Forty-four patients with postoperative severe type Ⅱ respiratory failure were randomly divided into two groups (22 in each group). In the control group, 10-20 mg of midazolam was given intravenously and propofol was injected intravenously After continuous infusion of 0.5 ~ 2.0 mg / (kg.h) of pump, the changes of pH, PaO2 and PaCO2, Pmax, Ppalt, PEF and FEV1 / FVC changes. Results: Compared with the control group, the PaCO2 in the propofol group decreased significantly after treatment, and the pH returned to the normal range within 1/2 h after the treatment, recovering more rapidly (P <0.05-0.01); after 1/2 h of treatment PaO2, PaO2 / Fi O2 than the control group were significantly higher. Propofol group after treatment, Pmax, Ppalt significantly decreased compared with the control group, PEF, FEV1 / FVC increased significantly (P <0.05 ~ 0.01). Conclusion: Sedation of propofol can reduce airway resistance, improve oxygenation function and reduce man-machine confrontation in the treatment of severe type Ⅱ respiratory failure after surgery.