标题：右美托咪定对机械通气患者脏器功能的保护作用

      作者：王琨，李海红，郑长伟，陈玲，崔轮盟 综述 谢凤杰 审校    牡丹江医学院附属红旗医院重症医学科，黑龙江 牡丹江 157000

      卷次： 2020年31卷18期

      【摘要】 重症加强护理病房中机械通气的患者常处于强烈的应激状态，易出现烦躁、焦虑、恐惧等不良情绪，发生人机对抗，影响机械通气的效果；应激还可诱导促炎细胞因子的释放，进一步加重脏器的损伤。因此，镇静、镇痛是重症加强护理病房中机械通气患者治疗的一部分。右美托咪定作为新型、高效、高选择性的α2肾上腺素受体激动剂，具有显著的镇静、镇痛及抗焦虑作用，对呼吸抑制作用轻微，无明显停药后的反跳现象，可减少谵妄的发生。近年来，随着对右美托咪定的深入研究，发现除了具有较好的镇静、镇痛作用外，还具有抗炎、抗氧化以及脏器功能保护的作用。本文主要综述右美托咪定对重症加强护理病房中机械通气患者各脏器功能的保护作用、对各种疾病治疗的协同作用及其机制，以供临床参考和借鉴。
      【关键词】 重症加强护理病房；机械通气；右美托咪定；脏器；保护；治疗；机制
      【中图分类号】 R56 【文献标识码】 A 【文章编号】 1003—6350（2020）18—2418—04

Protective effect of dexmedetomidine on organ function in patients with mechanical ventilation.
WANG Kun, LIHai-hong, ZHENG Chang-wei, CHEN Ling, CUI Lun-meng, XIE Feng-jie. Department of Intensive Medicine, HongqiHospital Affiliated to Mudanjiang Medical College, Mudanjiang157000, Heilongjiang, CHINA【Abstract】 Patients with mechanical ventilation in intensive care unit are often in a state of intense stress, proneto irritability, anxiety, fear and other negative emotions, resulting in human-machine confrontation and affecting the ef-fect of mechanical ventilation. Stress can also induce the release of proinflammatory cytokines, further aggravating thedamage to the organs. Therefore, sedation and analgesia are part of the treatment of patients with mechanical ventilationin the intensive care unit. Dexmedetomidine, as a new highly effective and highly selective α2 adrenergic receptor ago-nist, has significant sedative, analgesic and anti-anxiety effects. It has a slight effect on respiratory depression and no re-bound phenomenon after discontinuation, and can reduce the occurrence of delirium. In recent years, with the in-depthstudy of dexmedetomidine, it has been found that in addition to good sedative and analgesic effects, it also has anti-in-flammatory, anti-oxidant and organ protection functions. This article mainly reviews the protective effect of dexmedeto-midine on the functions of various organs in patients with mechanical ventilation in the intensive care unit, the synergis-tic effect on the treatment of various diseases and its mechanism, for clinical reference and reference.
      【Key words】 Intensive care unit; Mechanical ventilation; Dexmedetomidine; Organ; Protection; Treatment;Mechanism·综述·doi:10.3969/j.issn.1003-6350.2020.18.031基金项目：黑龙江省牡丹江市科学技术计划项目(编号：Z2017s0029)