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目的：观察异丙酚和芬太尼混合液对危重病人机械通气期间血流动力学的影响。方法：２４例病人随机分为对照组（ｎ＝１１）：机械通气期间间断用咪唑安定５～１０ｍｇ或芬太尼０．１～０．２ｍｇ静脉注射；异丙酚组（ｎ＝１３）：机械通气期间持续静滴异丙酚４００ｍｇ加芬太尼０．５ｍｇ混合液２ｍｇ·ｋｇ－１·ｈ－１。结果：入ＩＣＵ时两组心脏指数、血液饱和指数无差异，异丙酚组心脏指数逐渐升高，在入ＩＣＵ后第二天明显升高（Ｐ＜０．０５）。异丙酚组血液饱和指数增加显著（Ｐ＜０．０１），且与用药前相比增加显著（Ｐ＜０．０１）。异丙酚组病人平均主动脉压较对照组有所下降，但无统计学意义。异丙酚可使肺动脉压轻度下降，在以后的治疗中两组无差别。心率、中心静脉压、肺毛细血管楔压无明显变化。入ＩＣＵ时两组全身血管阻力无差异，异丙酚可降低全身血管阻力，在入ＩＣＵ后第二天下降明显（Ｐ＜０．０５）。异丙酚可使周围血管阻力下降（Ｐ＜０．０５）。结论：异丙酚和芬太尼混合液长期镇静对危重病人机械通气期间的血流动力学影响较小。
Objective: To observe the effects of propofol and fentanyl mixture on the hemodynamics during mechanical ventilation in critically ill patients. Methods: Twenty-four patients were randomly divided into control group (n = 11): intermittent use of midazolam 5 ~ 10mg or fentanyl 0.1 ~ 0.2mg intermittently during mechanical ventilation; propofol group (n = 13) During mechanical ventilation, continuous intravenous propofol 400mg plus fentanyl 0.5mg mixture 2mg · kg-1 · h-1. Results: There was no difference in heart index and blood saturation index between the two groups in ICU. The cardiac index in propofol group increased gradually and increased significantly on the second day after ICU admission (P <0.05). Propofol group, blood saturation index increased significantly (P <0.01), and compared with before treatment increased significantly (P <0.01). The mean aortic pressure in propofol group was lower than that in control group, but not statistically significant. Propofol mildly decreased pulmonary arterial pressure, with no difference between the two groups in later treatments. Heart rate, central venous pressure, pulmonary capillary wedge pressure no significant change. Into the ICU, there was no difference in systemic vascular resistance between the two groups. Propofol decreased systemic vascular resistance and decreased significantly the day after ICU admission (P <0.05). Propofol decreased peripheral vascular resistance (P <0.05). Conclusion: Long-term sedation of mixture of propofol and fentanyl has little effect on hemodynamics during mechanical ventilation in critically ill patients.