论著

应用膳食平衡指数评价溃疡性结肠炎患者膳食质量及营养状况

Evaluation of diet quality with DBI-07 and nutritional status of patients with ulcerative colitis

:34-38
 
目的 应用中国膳食平衡指数(DBI-07)对活动期溃疡性结肠炎(Ulcerative Colitis,UC)患者进行膳食质量评价,并分析其与营养指标、活动度等的关系,为UC患者制订科学的营养干预措施提供依据。方法 选取我院符合纳入标准的82例UC患者进行研究,用食物频率法对患者进行膳食调查,应用膳食平衡指数DBI-07评分系统进行评价,同时进行人体测量及营养指标测定。数据用SPSS 17.0软件进行处理分析。结果 本研究中68.3%的UC患者体质量近半年有不同程度降低,40.2%的患者存低白蛋白血症,34.1%的合并贫血。UC患者TS平均值-20.02±7.97; LBS平均值-22.15±6.78, 其中54.9%存在轻度膳食摄入不足、37.8%存在中度摄入不足;DQD平均值24.27±6.21,其中轻、中度失衡分别占80.5%、17.1%。LBS绝对值与体质量减轻程度呈正相关,P<0.05,与血清白蛋白负相关,P<0.01;DQD与白蛋白呈负相关,P<0.01;4 UC患者LBS绝对值与UC活动度呈正相关,P<0.01;DQD值与UC活动度负相关,P<0.01。结论 以中国膳食平衡指数DBI-07评价UC患者膳食质量,92.7%的患者存在低、中度摄入不足,97.6%的UC患者存在膳食失衡,均明显高于健康人群。摄入不足是UC患者营养不良的重要原因,应对UC患者进行营养补充或营养支持。
Objective To survey the diet quality of UC patients using Chinese diet balance index(DBI-07) and explore their relationship with nutritional index and activity of disease, thereby to provide evidences of nutritional therapy for UC patients. Methods 82 adult UC patients who met the inclusion criteria were included in our study. They were investigated with food frequency questionnaires(FFQ) and diet quality was assessed with DBI-07. Anthropometric measurement and blood examinations were done. Data were analyzed with SPSS 17 software. Results 68.3% of the UC patients loss their weight during the recent 6 months. 40.2% of the patients were found hypoalbuminemia and 34.1% were complicated with anemia. The mean TS,LBS and DQD were -20.02±7.97, -22.15±6.78 and 24.27±6.21 respectively. Percentage of patients in slightly or moderately deficit of food intake were 54.9% and 37.8%. Percentage of the UC patients in slightly or moderately dietary imbalance were 80.5% and 17.1%.The absolute value of LBS and DQD were negatively correlated with serum albumin respectively, and both of them were positively correlated with activity of UC. Conclusion Evaluating the quality of UC with DBI-07,92.7% of UC patients were in slightly or moderately deficit of food intake,97.6% were in slightly or moderately dietary imbalance. These percentages were higher than that of healthy people. It indicated that deficit of food intake is an important reason resulting in malnutrition. Nutrition therapy is essential for UC patients.
论著

广州地区老年人维生素D与骨密度、甲状旁腺激素的相关性研究

Study on the vitamin D status of elder people in Guangzhou and the relationship in vitamin D,bone mineral density and parathyroid hormone

:20-23
 
目的 探讨广州地区老年人维生素D水平及其与骨密度、甲状旁腺激素的相关性。方法 收集2016年6月—12月在广州市第一人民医院老年病科就诊的患者。检测25-羟维生素D、甲状旁腺激素、Ⅰ型前胶原氨基端前肽、β-Ⅰ型胶原C端肽、腰椎和髋部骨密度。将患者分为维生素D缺乏组(≤20 ng/mL)、维生素D不足组(20~30 ng/mL)、维生素D充足组(≥30 ng/mL)。结果 ①426例研究对象的平均年龄是(79.77±7.69)岁,25羟维生素D平均值是(20.38±8.20)ng/mL。维生素D缺乏、不足、充足者比例分别是53%(226/426)、34.3%(146/426)、12.7%(54/426)。②25羟维生素D水平随年龄增加而降低。25羟维生素D与股骨颈和全髋骨密度呈正相关(r=0.18,P<0.001),与甲状旁腺激素呈负相关(r=-2.05,P<0.001)。结论 广州地区老年人维生素D不足及缺乏十分普遍。维生素D与股骨颈、髋部骨密度呈正相关,与甲状旁腺激素呈负相关。
Objective To investigate the vitamin D level of elder people in Guangzhou and the relationship in vitamin D, bone mineral density and parathyroid hormone. Methods To screening elderly patients in the geriatric department of Guangzhou First peoples Hospital from June to December 2016.Serum 25-hydroxy vitamin D,parathyroid hormone,procollagen typeⅠN-terminal propeptide,β-crosslaps of C-telopeptide of typeⅠcollagen,bone mineral density were measured.Three groups were divided according to the serum 25(OH)D level,including deficiency group(≤20 ng/mL),insufficiency group(20-30 ng/mL) and sufficiency group(≥30 ng/mL). Results The mean age of the 426 subjects was 79.77±7.69 years old. The average level of 25(OH)D was 20.38±8.20 ng/mL. The proportion of vitamin D deficiency, insufficient and sufficient persons were 53% (226/426), 34.3% (146/426), and 12.7% (54/426). The level of 25 hydroxy vitamin D was decreased with age.Correlation analysis showed that 25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density(r=0.18,P<0.001),was negatively correlated with parathyroid hormone(r=-2.05,P<0.001). Conclusion Vitamin D deficiency or insufficiency is highly prevalent in elderly men in Guangzhou.25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density, negatively correlated with parathyroid hormone.
临床护理

整体护理对急性Stanford A型主动脉夹层(AAAD)患者围术期干预效果观察

Holistic nursing intervention effects in perioperative period ofacute Stanford A aortic dissection

:125-127
 
目的 急性Stanford A型主动脉夹层(AAAD)患者往往需急诊手术,以挽救其生命。手术通常存在高风险。术后常见并发症包括:神经系统、呼吸系统、胃肠道、肝、肾脏等多器官系统的功能障碍,以及全身感染,其使得术后过程更加复杂。 因此, 围术期护理极为重要。方法 2016年2月—2018年2月, 共完成了24 例 AAAD患者的手术。术前所有病人收治科室ICU。手术方式为Bentall+Sun'氏术。 围术期,对患者随机分组进行密切观察和护理。A组:常规组(routine nursing):对患者给予常规护理;B组:整体组(integrated nursing):除了常规的基本护理外,加强了围术期镇静、镇痛和术后并发症的专业化的整合护理。结果 两组共24例成功完成了手术。两组术前资料比较,无显著差异。整体护理组ICU停留时间和住院时间短于常规组(P<0.05);护理满意度、生活质量比较,整体组患者优于常规组(P<0.05)。结论 护士提供的围术期专业化技术的整体护理,可改善患者围术期的治疗效果,促进康复。
论著

教育干预对护士预防误吸知识和护理行为的影响研究

The effect of educational intervention on nurse′s knowledge of preventing aspiration and nursing behavior

:115-117
 
目的 对临床护士实施预防住院患者误吸教育干预,评价干预措施对护士预防误吸知识及护理行为的影响。方法 选取我院神经系统相关科室的110名护士为研究对象,通过一系列教育干预,对比干预前后护士在预防误吸知识及护理行为等方面的改变,评估干预措施的效果。结果 110名护士均对培训满意;培训前护士预防误吸知识的平均得分为(65.6±9.6)分,培训后平均得分为(92.5±6.5)分,培训前后得分的差异有统计学意义(P<0.05)。培训后89份(89%)跟踪调查卷明确表示护士在工作中运用了培训所学的知识。结论 对护士进行有组织、有计划的教育干预能提高护士预防与处理患者误吸的知识水平,并能对护士预防和处理患者误吸的行为产生积极影响。
Objective To evaluate the effect of educating nurses on how to prevent and reduce aspiration rate of patients. Methods 110 nurses were recruited from neurological department in our hospital and were trained systematically about the prevention and nursing of aspiration. We compared the scores they had before and after training. Results 110 nurses were all satisfied with the training. The pre-education test score about the aspiration knowledge was 65.6±9.6 while the post-education test score was 92.5±6.5. The difference of the score before and after training was statistically significant difference (P<0.05). The follow-up study indicated that 89% nurses are applying the knowledge gained from the training to their clinical work. Conclusion It's suggested that well-organized educational training may improve nurses' performance of preventing patients from aspiration and treating patients when they had aspiration, which left a positive effect on nurses' behavior.
论著

超声检查前准备质量评价对病人超声检查效果的影响

Preoperative quality evaluation on patients′ ultrasonic examination results

:108-110
 
目的 分析超声检查前准备质量评价对超声检查效果的影响。方法 对进行泌尿科B超检查150例患者按数字表法随机分为对照组和实验组各75例,两组患者发放超声检查须知,按检查准备要求按预约时间前来完成超声检查;实验组在检查前对患者准备效果进行评价,及时落实检查须知事项。结果 检查前准备知识知晓、检查前准备质量、按时检查率对照组低于实验组(P<0.05);检查前准备依从性、服务满意度对照组低于实验组(P<0.05)。结论 开展检查前准备质量评价能促进患者落实超声检查前准备,提高准备依从性和准备知识知晓率,缩短检查等候时间,提高检查前准备质量和患者服务满意度。
Objective To analyze the influence of pre-preparation quality evaluation on the effect of ultrasound examination. Methods According to the digital table method, 150 patients were randomly divided into the control group and the experimental group, 75 cases in the control group and the experimental group each. The two groups were taken the ultrasound examination, and the ultrasound examination was completed according to the preparation requirements. The patients in the experimental group were evaluated before the examination, and the inspection notes were timely implemented. Results Knowledge of pre preparation, preparation quality before examination, and rate of check on time were lower in the control group than that in the experimental group(P<0.05). The control group was lower than the experimental group(P<0.05). Conclusion The preparation quality evaluation before examination may promote the patient's preparation before the ultrasonic examination, improve the preparation compliance and knowledge awareness, shorten the waiting time, and improve the quality of preparation and the satisfaction of patient service.
论著

腹主动脉瘤腔内治疗并发症的处理策略

The handling strategy of complications of abdominal aortic aneurysm after endovascular repair

:40-43
 
目的 探究和分析本组腹主动脉瘤腔内治疗病例并发症发生的原因及预防、处理策略。方法 对本团队在2014年1月—2017年12月实施的37例腹主动脉瘤腔内修复手术病例进行回顾性分析。结果 共有11例发生并发症,其中3例为术中I型内漏、1例术后支架移位致Ⅰ型内漏、1例术后Ⅲ型内漏、1例术中Ⅳ型内漏,全部经处理后内漏消失;术后髂动脉支架内血栓1例,经取栓后血流恢复;术后股动脉狭窄闭塞1例,经取栓并行股动脉人工血管置换后血流恢复;术后移植物反应1例,对症处理后症状消失出院;2例双侧髂内动脉栓塞致术后盆腔疼痛,随访疼痛消失,无跛行。结论 腹主动脉瘤腔内修复治疗本身存在内漏、血栓、血管入路损伤、移植物反应等相关并发症。术前正确评估并严格掌握适应症以及具有成熟的操作经验,是减少并发症发生的关键。
Objective To discuss and analyze the occurrence causes, prevention and treatment methods of complications in the endovascular repair of patients with abdominal aortic aneurysm. Methods Totally 37 cases of patients with abdominal aortic aneurysm underwent endovascular repair in our hospital from January 2014 to December 2017 were retrospectively analyzed. Results The complications were occurred in 11 cases, which including intra-operative typeⅠendoleak in 3 cases, postoperative typeⅠendoleak caused by stent displacement in 1 case; intra-operative type Ⅲ endoleak in 1 case; postoperative type Ⅳ endoleak in 1 case. all of the endoleak events disappeared after dealing. There was postoperative iliac artery stent thrombosis in 1 case, the blood flow was restored after thrombectomy; postoperative femoral artery stenosis or occlusion in 1 case, the blood flow was restored after thrombectomy and femoral artery artificial vascular replacement; postoperative host versus graft reaction in 1 case, no stent infection was found; and postoperative bilateral pelvic pain caused by internal iliac artery embolization in 2 cases, the pain disappeared during the follow-up visit, and the patients were free from lameness. Conclusion The complications related to endoleak, thrombosis, vascular approach injury and host versus graft reaction are existing with the endovascular repair itself of abdominal aortic aneurysm. The correct preoperative evaluation as well as strict control of indications and mature operational experience are the key to reduce the occurrence of complications.
论著

急性呼吸窘迫综合征患者血清甲状腺素水平变化

Serum thyroid hormone level change of acute respiratory distress syndrome

:33-35
 
目的 研究分析急性呼吸窘迫综合征(ARDS)患者血清甲状腺素变化与疾病的严重程度的相关性。方法 选取2016年1月—2018年1月在我院重症医学科收治的123例急性呼吸窘迫综合征及41例非急性呼吸窘迫综合征患者,根据2012柏林定义,ARDS又再划分为轻度组(26.67 kPa2/FiO2≤40.00 kPa,PEEP或CPAP≥0.49 kPa)、中度组(13.33 kPa2/FiO2≤26.67 kPa,PEEP≥0.49 kPa) 及重度缺氧组(PaO2/FiO2≤13.33 kPa,PEEP≥0.49 kPa),同时再选取同一时段内在我院进行常规体检的41例健康成人作为对照,对他们血清的甲状腺激素水平测定。结果 健康成人对照组与非ARDS组比较, 血清TSH、FT4、TT4、FTS、TT3水平测定差异没有统计学意义(P>0.05),ARDS组较另外两组以上指标均有降低(P<0.05),轻、中、重三组间比较,血清甲状腺素的差异存在统计学意义。结论 急性呼吸窘迫综合征患者血清甲状腺素水平与缺氧程度呈正相关,随着疾病严重程度加大,其水平差异的变化更加明显,动态监测甲状腺素水平对疾病严重程度的判断和对预后的评估具有重大意义。
Objective To analyze serum thyroid hormone level change of acute respiratory distress syndrome and the correlation between the severity of disease. Methods 123 cases (including mild 26.67 kPa2/FiO2≤40.00 kPa,PEEP or CPAP≥0.49 kPa,moderate 13.33 kPa 2/FiO2≤26.67 kPa,PEEP≥0.49 kPa and severe PaO2/FiO2≤13.33 kPa,PEEP≥0.49 kPa)of patients with acute respiratory distress syndrome and 41 cases of non-ARDS were involved. from January 2016 to January 2018 in our hospital and 41 cases of healthy people by routine check-up in our hospital during the same period were selected,then the serum thyroid hormone levels were determined. Results Compared with healthy control group,TSH、FT4、TT4、FTS、TT3 level in non-ARDS group has no statistical difference(P>0.05),while compared with the rest of the two groups,all indexes in ARDS group were lower (P<0.05). And TSH、FT4、TT4、FT3、TT3 levels in moderate ARDS group decreased compared with those in relatively mild ARDS (P<0.05). The level of each index in severe ARDS group decreased compared with the moderate ARDS group (P<0.05). There was statistical difference in detection index level in three groups. Conclusion The serum thyroid hormone level of ARDS patients is positively correlated with hypoxemia. As the pathological severity changes ,the level of hypoxemia changes are more apparent. Dynamic monitoring of serum thyroid hormone is of great significance in severity judgement and prognosis evaluation.
论著

入院首次中性粒细胞/淋巴细胞比值与急性心肌梗死患者院内主要不良心血管事件发生的相关性研究

The correlation between neutrophil/lymphocyte ratio and in-hospital major adverse cardiac events in patients with acute myocardial infraction at the early admission

:13-17
 
目的 探讨急性心肌梗死患者入院首次中心粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与院内主要不良心血管事件(MACE)发生的相关性。方法 回顾分析2016年1月—2016年12月入住我院的急性心肌梗死患者179例,分为发生院内不良事件组(n=46)和未发生组(n=133)。采用单因素及多因素Logistics回归分析评估NLR与MACE风险的相关性。结果 179例患者中,46例患者发生院内MACE。发生院内MACE组患者的淋巴细胞计数低于未发生组(P<0.05),NLR高于未发生组(P<0.05),发生院内MACE组患者入院时的心、肾功能较未发生组差(P<0.05)。单因素回归分析显示,NLR水平与院内MACE发病率相关(OR=1.079,95%CI:1.014~1.147, P<0.05)。多因素logistic回归分析校正性别、年龄、高血压病史、糖尿病史、Killip II级以上、收缩压、入院首次白细胞、eGFR、超敏C反应蛋白、左室射血分数及多支病变后显示,NLR是院内MACE的独立危险因素(OR=1.182,95%CI:1.034~1.352,P<0.05);此外,超敏C反应蛋白及LVEF<50也是院内MACE的独立危险因素(P<0.05)。结论 入院首次高NLR与急性心肌梗死患者发生院内MACE相关,是患者发生院内MACE的独立危险因素。
Objective To explore the correlation between first neutrophil/lymphocyte ratio(NLR) and in-hospital major adverse cardiac events (MACE) in patients with in patients with acute myocardial infarction. Methods Total of 179 patients with acute myocardial infarction in Guangzhou First People's Hospital from Jan 2016 to Dec 2016 were enrolled. MACE was defined as malignant arrhythmia, recurrence of myocardial infarction, target vascular reconstruction, acute left heart failure, stroke, cardiac shock and death.Baseline data and in-hospital clinical adverse events were compared among two groups. All patients were divided into two groups:MACE(+) group and MACE(-) group. Univariate and multivariate logistic regression was used to assess the correlation between NLR and in-hospital MACE. Results In-hospital MACE occurred in 46(25.7%)patients. Univariate logistic analysis showed that NLR was strongly related with MACE incidence(OR=1.079,95%CI:1.014~1.147, P<0.05). Multivariate logistic regression analysis found that after adjusting other traditional risk factors including female gender, age, hypertension,diabetes, overKillip II grade, systolic blood pressure,first white blood cells after admitted,basic renal dysfunction,Hs-CRP,LVEF and multivessel lesions. NLR was still a significant independent predictor of in-hospital MACE in patients with acute myocardial infarction. Additionally, hs-CRP and LVEF<50% were also associated with in-hospital MACE(P<0.05). Conclusion NLR is the independent risk factor for in-hospital MACE occurrence in acute myocardial infarction at the early admission.
论著

自体心包膜移植对心肌梗死大鼠心功能的影响

Effect of autologous pericardial patch transplantation to cardiac function after treating the myocardial infarction in experimental rats

:1-4
 
目的 探讨自体心包膜组织对急性心肌梗死大鼠心脏功能的影响。方法 筛选合格的模型动物随机分为三组:心包去除组:仅去除心包膜;心梗组:前降支结扎法建立大鼠心肌梗死模型3周后仅开胸;移植组:前降支结扎法建立大鼠心肌梗死模型,3周后将心包膜移植于心肌梗死及周边区。实验4周后,通过心动图评价实验动物心脏功能,使用Masson染色检测动物心肌梗死大小,通过免疫荧光评价动物心肌存活率、观察血管新生状况,Western blot检测Caspase-3蛋白/Bcl-2基因表达情况。结果 4周后,心包去除组大鼠的心电图监测结果未见有室性颤动;而心梗组、心梗+移植组均有非致死性室性颤动。相比心梗组,心梗+移植组改善了心功能,降低了心肌凋亡指数,免疫Bcl-2蛋白表达升高,而Caspase-3蛋白表达降低。结论 提示自体心包膜移植不会导致恶性室性心律失常,相对有较高的安全性;并能促进心肌梗死细胞恢复心功能,其改善机制可能与通过修补心室重构途径同时抑制缺血区域细胞凋亡有关。
Objective To explore the effect of autologous pericardial transplantation for treating the myocardial infarction (MI) in experimental rats. Methods 30 SD rats were randomly divided in to three equal parts: Pericardial removal group (PR group): only pericardium tissue was removed; Myocardial infarction group (MI group): the anterior descending branch ligation method established a rat model of myocardial infarction and only opened the chest after 3 weeks. Autologous pericardium transplantation (APT group): After established the MI model of SD rats, 3 weeks later, the autologous pericardial patch was harvested and transplanted to infarcted zone. Four weeks after the surgery, the cardiac function and serum biochemistry were analyzed for all the experimental rats. The cardiac function was evaluated by echocardiography, which the size of the infarction were examined by Masson staining, the survival time of transplanted autologous pericardial and angiogenesis were measured by immunohistochemistry, the protein expressions of Caspase and the gene expressions of Bcl were examined by Western blot analysis. Results 4 week after the 2nd operation, no ventricular fibrillation was detected in the ECG of PR group. Fatal ventricular fibrillation wasn't detected in the ECG of MI group and APT group. Compared with MI group, APT group improved cardiac function and decreased myocardial apoptosis index(P<0.05),which similar to PR group. APT group has the higher density of angiogenesis at infracted area to MI group but less than that of PR group. PT group had decreased protein expressions of Caspase-3 and the expressions of Bcl-2 were decreased. Conclusion Autologous pericardial transplantation could recover myocardial infarction cells, which will improve the cardiac function in experimental rats with MI.
论著

静脉泵注不同剂量右旋美托咪定对患者呼吸力学及镇静深度的影响

The effect of intravenous injection of different doses of dexmedetomidine on respiratory mechanics and the depth of sedation in patients

:17-23
 
目的 本研究旨在采用连续气道监测法对患者呼吸力学指标进行动态观察,同时监测脑电双频指数(Bispectral index,BIS)和清醒镇静评分(The Observer's Assessment of Alertness/Sedation Scale,OAA/S),全面系统地评估右旋美托咪定(dexmedetomidine ,Dex)对患者自主呼吸功能和镇静深度的影响,为Dex临床安全应用提供参考依据。方法 80例患者随机分为四组,Dex 0.5 μg/kg组(D1组),1.0 μg/kg组(D2组),1.5 μg/kg组(D3组)和对照组(D0组),每组病人20例。麻醉诱导前35min分别静脉泵注Dex或0.9%生理盐水10 mL。记录预先给药前(T0 )、预处理后5min(T1)、10min(T2)、15min(T3)、20min(T4)、25min(T5)和30min(T6)患者的潮气量(VT)、分钟通气量(MV)、呼气末二氧化碳分压(PETCO2)、呼吸频率(RR)、第一秒呼出率(FEV1%)、顺应性环(PV环)、阻力环(FV环)、脉搏氧饱和度(SpO2)、心率(HR)、平均动脉压(MAP)等呼吸力学参数和循环参数及脑电双频谱指数(BIS)及警觉/镇静评分(OAA/S),并于T0、T1、T3和T6抽取动脉血行血气分析记录PaO2、PaCO2和pH值。结果 与对照组相比,D1组的VT、RR、MV、PETCO2、FEV1%、PaCO2和SpO2均无变化(P>0.05),PV环和FV环形态基本正常;D2组和D3组MV分别降低16.9%和27.0%;PaCO2分别升高11.0%和19.9%;FEV1%分别下降11.0%和14.9%。四组患者均无发生呼吸暂停,而且所有患者SpO2均在98%或以上。D3组自主呼吸的PV环和FV环图形面积明显缩小(P<0.05)。D1组BIS值均在85以上,OAA/S 4分为65%,镇静满意率低,OAA/S 3分仅20%;D2组镇静满意率最高,OAA/S 3分达70%,且无出现过度镇静;D3组有60%患者OAA/S评分小于或等于2。结论 静脉泵注Dex所产生的的镇静效应及其对呼吸力学的影响,随着泵注Dex剂量增大,患者镇静程度加深,虽然SpO2仍在正常范围,但呼吸会受到一定抑制(PV环和FV环图形面积缩小,PaCO2 均上升),临床推荐静脉泵注Dex剂量为0.5 μg/kg~1 μg/kg以策安全。
Objective The purpose of this study was to observe the dynamic indexes of respiratory mechanics in patients with continuous airway monitoring,and to monitor the Bispectral index (BIS) and the Observer's Assessment of Alertness/Sedation Scale (OAA/S). We evaluated the effect of dexmedetomidine (Dex) on the autonomic respiratory function and the sedative depth of the patients in a comprehensive and systematic way,so as to provide reference for the clinical safety of Dex. Methods In the study,we randomly divided 80 patients into four groups,Dex 0.5,group g/kg (group D1),1 group g/kg (group D2),1.5 g/kg group (D3 group) and control group (D0 group). There were 20 cases in each group. At about 35min before anesthesia induction,Dex or 0.9% saline 10 mL was injected intravenously. The following time points were selected: pre- administration (T0),pre-treated 5min (T1),pre-treated 10min (T2),pre-processed 15min (T3),pre-processed 20min (T4),pre -treated 25min (T5) and pre-treated 30min. The following experimental parameters were recorded at the above time point: tidal volume (VT),minute ventilation (MV),end expiratory carbon dioxide partial pressure (PETCO2),respiratory frequency (RR),first second exhalation rate (FEV1%),compliance ring (PV ring),resistance ring (FV ring),pulse oxygen saturation (SpO2),heart rate (HR),and respiratory mechanics parameters and circulatory parameters such as mean arterial pressure (MAP),bispectral index (BIS) and vigilance / sedation score (OAA/S). At the same time at T0,T1,T3 and T6,arterial blood gas was extracted,and PaO2,PaCO2 and pH values were recorded. Results Compared with the control group,the value of VT,RR,MV,PETCO2,FEV1%,PaCO2 and SpO2 in group D1 did not change significantly (P>0.05),and the morphology of PV ring and FV ring were basically normal. In group D2 and group D3,MV decreased by 16.9% and 27% respectively;PaCO2 increased by 11% and 19.9% respectively;FEV1% decreased by 11% and 14.9% respectively. No apnea occurred in the four groups,and all patients had SpO2 at 98% or above. The area of PV rings and FV rings of spontaneous breathing in group D3 was reduced (P<0.05). The BIS values in group D1 were above 85,OAA/S 4 was 65%,sedative satisfaction rate was low,20% patients had a score of 3 in OAA/S;group D2 had the highest sedative satisfaction rate,70% of patients had a score of 3 in OAA/S,and no excessive sedation;60% of patients in group D3 with an OAA/S score that was less than or equal to 2. Conclusion The sedation effect that was caused by intravenous infusion of Dex and its effect on respiratory mechanics are as follows: with the increase of Dex's dose,the degree of sedation is deepened. Although SpO2 is still in the normal range,the respiration will be restrained (the area of PV ring and FV ring is narrowed,the value of PaCO2 is increased),and the clinical recommendation of intravenous infusion Dex is at a dose of 0.5µg /kg~1µg /kg for safety reasons. .
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