中文摘要：

【摘要】目的观察丙泊酚持续镇静在连续性静一静脉血液透析滤过（CVVHDF）患者中的疗效。方法回顾性分析海南医学院附属医院急诊重症监护病房（ICU）2009年4月至2011年6月使用丙泊酚持续镇静的74例患者的临床疗效，其中并发急性肾功能不全需要进行CVVHDF者26例，其他不需进行CVVHDF的危重患者48例，对比分析两组患者丙泊酚的持续给药时间、药物总剂量、清除率及苏醒时间；同时监测26例行CVVHDF治疗者回路流入侧和流出侧的丙泊酚血药浓度。结果与非CVVHDF组比较，CVVHDF组丙泊酚持续镇静需要更长的给药时间（h：298．37±28．73比173．44±17．27，P〈0．05）和更大的给药剂量（g：35．89±0．76比21．82±0．62，P〈0．05）；而CVVHDF组和非CVVHDF组丙泊酚持续给药后2、6、24h的药物清除率（m~min，2h：13．85±1．15比14．41±1．21，6h：5．92±0．52比6．32±0．59，24h：4．75±0．41比5．33±0．45）及苏醒时I司（min：8．89±1．46比8．47±1．37）比较差异均无统计学意义（均P〉0．05）。26例CVVHDF患者给予丙泊酚持续镇静后CVVHDF回路流入侧和流出侧的丙泊酚血药浓度无明显变化。结论与非CVVHDF患者相比，CVVHDF患者使用丙泊酚时需要更大的给药剂量和更长的持续给药时间才能维持其良好的镇静作用，但两组对丙泊酚的清除率相同，都能够维持稳定的血药浓度，不会影响患者苏醒，且无并发症发生。

英文摘要：

Objective To study the use of propofol sedation in patients undergoing continuous venous-venous haemodiafiltration （CVVHDF） and assess the curative effects. Methods A retrospective study was conducted. Data from 74 patients with continuous sedation of propofol in emergency intensive care unit （ICU） from April 2009 to June 2011 were analyzed. There were 26 cases suffering from acute renal failure in CVVHDF group and 48 critical cases in non-CVVHDF group. Propofol administration duration, dose, the clearance rate and the average recovery time in both groups were analyzed, and plasma concentrations of propofol at inflow side and outflow side of CVVHDF circuit in 26 patients with CVVHDF were determined. Results Compared with non-CVVHDF group, it took a longer administration time （hours： 298.37 ± 28.73 vs. 173.44 ± 17.27, P〈O.05） and higher close （g： 35.89 ± 0.76 vs. 21.82 ± 0.62, P〈 0.05 ） in CVVHDF group. There were no statistical significances on clearance rate at 2, 6, 24 hours after administration （mYmin, 2 hours： 13.85 ± 1.15 vs. 14.41 ± 1.21, 6 hours： 5.92 ±0.52 vs. 6.32 ±0.59, 24 hours： 4.75 ±-0.41 vs. 5.33 ± 0.45 ） and recovery time （minutes： 8.89 ± 1.46 vs. 8.47 ± 1.37） between CVVHDF and non-CVVHDF groups （all P〉O.05）. Plasma concentrations of propofol at inflow side and outflow side of CVVHDF circuit were not different after propofol administration in 26 CVVHDF patients. Conclusions Compared with patients in non-CVVHDF group, the patients who received propofol in CVVHDF required higher total dosage and longer delivery time to maintain a good sedation. In both two groups clearance rate of propofol and maintenance of a stable blood concentration were the same. The use of a proper dose of propofol in CVVHDF did not affect wake up time of the patients, there were no complications.