床边超声评估纳布啡联合瑞芬太尼对机械通气患者胃排空功能的影响

doi:10.3969/j.issn.1006-6233.2021.05.033

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摘要 目的: 探讨纳布啡联合瑞芬太尼对机械通气患者胃排空功能的影响。方法: 选取本院2020年7月至12月收治需机械通气治疗的患者100例,随机分为瑞芬太尼组和联合组,各50例。两组患者均行机械通气治疗,瑞芬太尼组给予瑞芬太尼持续静脉泵入48h进行镇痛镇静治疗,联合组在使用瑞芬太尼同时给予纳布啡持续静脉泵入48h。采用超声检测镇痛镇静前及镇痛镇静48h后胃排空时间(GET)、胃窦运动指数(MI);记录镇痛镇静前及镇痛镇静后1h、2h、12h、24h、48h心率(HR)、平均动脉压(MAP);观察两组患者治疗过程中不良反应发生情况。结果: 两组患者镇痛镇静后GET延长,MI降低,且联合组GET缩短,MI升高(P<0.05)。两组患者镇痛镇静后1h、2h、12h、48hHR减慢、MAP降低(P<0.05),两组患者镇痛镇静后各时间点HR、MAP比较,差异无统计学意义(P>0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论: 纳布啡联合瑞芬太尼可缩短机械通气患者GET,升高MI,且不增加不良反应发生率,安全可靠。

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关键词 ：机械通气, 瑞芬太尼, 纳布啡, 超声, 胃排空

Abstract：Objective: To investigate the effect of nalbuphine combined with remifentanil on gastric emptying function in mechanically ventilated patients. Methods: A total of 100 patients requiring mechanical ventilation were selected from this hospital from July to December 2020, and they were randomly divided into remifentanil group and combination group, with 50 cases in each group. Both groups were treated with mechanical ventilation. The remifentanil group was given continuous intravenous pumping of remifentanil for 48 hours for analgesia and sedation, and the combination group was given remifentanil and given nalbuphine continuous intravenous pumping for 48 hours. Ultrasound was used to detect the gastric emptying time (GET) and motility index (MI) before analgesia and 48 hours after analgesia and sedation. Analgesia before and after analgesia and sedation 1 hour, 2 hours, 12 hours, 24 hours, 48 hours,heart rate (HR) and mean arterial pressure (MAP) were recorded. The occurrence of adverse reactions of patients were observed. Results: After analgesia and sedation, GET was prolonged and MI decreased in the two groups, and GET was shortened and MI increased in the combined group (P<0.05). HR slowed and MAP decreased at 1 hour, 2 hours, 12 hours, 24 hours, 48 hours after analgesia and sedation in the two groups (P<0.05). There was no significant difference in HR and MAP at each time point after analgesia and sedation in the two groups (P>0.05). There was no significant difference in the adverse reaction rate between the two groups (P>0.05). Conclusion: Nalbuphine combined with remifentanil is safe and reliable, can shorten the GET of mechanically ventilated patients, and increase the MI without increasing the incidence of adverse reactions.

Key words： Mechanical ventilation Remifentanil Nalbuphine Ultrasound Gastric emptying

基金资助:江苏省临床医学科技专项项目(编号:BL2014100);江苏省宿迁市科技局指令性计划课题(编号:S201517)

通讯作者: 林爱华

引用本文:

倪逊, 许可, 丁婷婷, 巩丹丹, 陆姗姗, 林爱华. 床边超声评估纳布啡联合瑞芬太尼对机械通气患者胃排空功能的影响[J]. 河北医学, 2021, 27(5): 855-859.
NI Xun, XU Ke, DING Tingting, et al. Bedside Ultrasound Evaluation of the Effect of Nalbuphine Combined with Remifentanil on Gastric Emptying Function in Mechanically Ventilated Patients. HeBei Med, 2021, 27(5): 855-859.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.05.033 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I5/855

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