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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

29卷

期数:

2023年06期

页码:

632-635,661

栏目:

临床医学

出版日期:

2023-11-20

文章信息/Info

Title:

Effect of early goal-directed sedation on PGⅠ， PGⅡ and G17 in patients with acute severe intracerebral hemorrhage

文章编号:

1006-8147(2023) 06-0632-05

作者:

张苏明¹; 2; 晁亚丽²; 李大辉³ ; 李莉³; 柴艳芬¹

（1.天津医科大学总医院急诊医学科，天津 300052；2.徐州医科大学附属医院重症医学科，徐州 221000；3.徐州医科大学附属医院麻醉科，徐州 221000）

Author(s):

ZHANG Su-ming¹; 2;  CHAO Ya-li²;  LI Da-hui³;  LI Li³;  CHAI Yan-fen¹

（1.Department of Emergency Medicine， General Hospital， Tianjin Medical University， Tianjin 300052， China；2.Department of Intensive Care Unit， The Affiliated Hospital of Xuzhou Medical University， Xuzhou 221000， China；3.Department of Anesthesiology， The Affiliated Hospital of Xuzhou Medical University， Xuzhou 221000， China）

关键词:

早期目标导向镇静; 脑出血; 胃功能; 胃蛋白酶原

Keywords:

early goal-directed sedation;  intracerebral hemorrhage;  gastric function;  pepsinogen

分类号:

R459.7

DOI:

-

文献标志码:

A

摘要:

目的：探讨早期目标导向镇静（EGDS）对急性重症脑出血患者血清胃蛋白酶原Ⅰ（PGⅠ）、胃蛋白酶原Ⅱ（PGⅡ）和胃泌素17（G17）的影响。方法：选择2020年6月—2022年6月徐州医科大学附属医院重症医学科收治的69例急性重症脑出血患者作为研究对象，按随机数字表法分为EGDS组（n=35）和按需镇静组（n=34）。所有患者均给予瑞芬太尼维持镇痛，EGDS组持续静脉泵注右美托咪定镇静，按需镇静组则静脉推注丙泊酚按需镇静。观察两组患者镇静前及镇静3、7 d的血清 PGⅠ、PGⅡ、PGR（PGⅠ与PGⅡ的比值）和G17指标变化、镇痛药物总量、机械通气时间和ICU住院时间。结果：镇静3 d，EGDS组血清PGⅠ、PGⅡ明显低于按需镇静组（t=2.763、2.255，均P<0.05），两组血清PGR、G17差异无统计学意义（均P>0.05）；镇静7 d，EGDS组血清PGⅠ、PGⅡ、G17明显低于按需镇静组（t=2.538、2.200、2.858，均P<0.05），两组血清PGR差异无统计学意义（P>0.05）；与按需镇静组比较，EGDS 组镇痛药物使用量、机械通气时间和ICU住院时间均显著减少（t=4.350、2.300、2.193，均P<0.05）。结论：EGDS能改善急性重症脑出血患者血清胃功能指标，减少阿片类镇痛药物用量，缩短机械通气时间和ICU住院时间。

Abstract:

Objective： To investigate the effect of early goal-directed sedation （EGDS） on serum pepsinogenⅠ （PGⅠ）， pepsinogenⅡ （PGⅡ）， gastrin 17 （G17） in patients with acute severe intracerebral hemorrhage. Methods：A total of 69 patients with acute severe intracerebral hemorrhage who were admitted to intensive care unit （ICU） of the Affiliated Hospital of Xuzhou Medical University from June 2020 to June 2022 were included and randomly divided into EGDS group （n=35） and standard sedation （STD） group （n=34） using the random number table. All patients were given remifentanil for analgesia. Patients in the EGDS group were sedated by continuous intravenous infusion of dexmedetomidine. Patients in the STD group received intravenous bolus of propofol as appropriate clinically. The serum PGⅠ， PGⅡ， PGR（the ratio of PGⅠ to PGⅡ）， G17， analgesic dosage， duration of mechanical ventilation and length of ICU stay were observed in two groups of patients before sedation and on the 3rd， 7th days after sedation. Results：On the 3th day after sedation， serum PGⅠ and PG in EGDS group were significantly lower than those in STD group（t=2.763，2.255，all P<0.05）， and there were no significant differences in serum PGR and G17 between the two groups（all P>0.05）. On the 7th day after sedation，serum PGⅠ，PGⅡ and G17 in EGDS group were significantly lower than those in STD group（t=2.538，2.200，2.858，all P<0.05），and there was no significant difference in serum PGR between the two groups（P>0.05）. Analgesic dosage， duration of mechanical ventilation and length of ICU stay in the EGDS group were significantly reduced，compared with the STD group（t=4.350，2.300，2.193，all P<0.05）. Conclusion：EGDS can improve serum gastric function， reduce the dosage of opioids， duration of mechanical ventilation and length of ICU stay in patients with acute severe intracerebral hemorrhage.

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相似文献/References:

备注/Memo

备注/Memo:

基金项目 天津市医学重点学科（专科）建设项目（TJYXZDXK-007A）；吴阶平医学基金会临床科研专项资助基金（320.6750.2021-08-3）；徐州市科学技术项目（KC17172）
作者简介 张苏明（1987-），男，博士在读，研究方向：重症医学及脓毒症机制；通信作者：柴艳芬，E-mail：chaiyanfen2012@126.com。

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更新日期/Last Update: 2023-12-01