copd患者的镇静问题 课件.pptVIP

《抗菌药物临床应用指导原则2015解读奥美拉唑对抗利血平引起的胃溃疡作用鼻出血的护理课件鼻中隔偏曲病人的护理查房 阿尔茨海默症防治相关知识埃及的金字塔有建造方法动画艾司洛尔在神经外科重症中的应用二级二班防溺水等安全教育 《抗菌药物临床应用指导原则2015解读奥美拉唑对抗利血平引起的胃溃疡作用鼻出血的护理课件鼻中隔偏曲病人的护理查房 阿尔茨海默症防治相关知识埃及的金字塔有建造方法动画艾司洛尔在神经外科重症中的应用二级二班防溺水等安全教育 COPD患者应慎重应用镇静 1、COPD的镇静催眠问题； 2、长期口服镇静催眠药物的呼吸不良事件； 3、短期静脉应用镇静的心肺问题； 4、无创辅助通气时应用镇静的问题 COPD与睡眠 1、Up to 50% of their patients with COPD experience sleep abnormalities【1】. Dyspnea；cough and excessive mucus；the supine position；ventilator effort；nocturnal desaturations and hypercapnic episodes；drugs 2、Sleep-related complaints are ranked third complaints of patients with COPD【2】. 1、Stege G, Vos PJ, van den Elshout FJ, Richard DPN, van de Ven MJ, Heijdra YF. Sleep, hypnotics and chronic obstructive pulmonary disease. Respir Med. 2008. 102(6): 801-14. 2、Kinsman RA, Yaroush RA, Fernandez E, Dirks JF, Schocket M,Fukuhara J. Symptoms and experiences in chronic bronchitis and emphysema. Chest 1983;83:755–61. seven studies with patients with COPD showed adverse respiratory effects associated with NBBRAs and benzodiazepines, where seven others did not. more adverse effects were seen with longer acting benzodiazepines. Limited duration. varying severity of COPD. Different pharmacodynamics various respiratory parameters1、Stege G, Vos PJ, van den Elshout FJ, Richard DPN, van de Ven MJ, Heijdra YF. Sleep, hypnotics and chronic obstructive pulmonary disease. Respir Med. 2008. 102(6): 801-14. hypnotics, particularly benzodiazepines, should be avoided, if possibley,although there is evidence that some hypnotics, such aszolpidem, can be used in less severe COPD without significant adverse effects on gas exchange1. 1.Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–46. 长期口服镇静催眠药物的呼吸不良事件 长期 催眠药物对慢性COPD患者的影响 Chung WS, Lai CY, Lin CL, Kao CH. Adverse Respiratory Events Associated With Hypnotics Use in Patients of Chronic Obstructive Pulmonary Dis