瑞芬太尼复合咪达唑仑用于原发性高血压乳腺肿物切除术40例临床研究  

Study on Clinical Application of Remifentanil Combined with Midazolam in Primary Hypertension Patients undergoing Breast Tumor Resection on 40 Cases

作　　者：齐爱玲 李月鹏[2] 孟凡浩[2] 张永昌[2] 刘洪涛[2] 张玲玲[2] 张敏[2] 

机构地区：[1]河北省霸州市第二医院麻醉科,河北廊坊065701 [2]中国石油天然气集团公司中心医院麻醉科,河北廊坊065000

出　　处：《中国药业》2015年第5期10-12,共3页China Pharmaceuticals

基　　金：河北省廊坊市科学技术局科研项目;项目编号:2011013019

摘　　要：目的探讨瑞芬太尼复合咪达唑仑用于原发性高血压患者行乳腺肿物切除术中的麻醉效果及安全性。方法采用随机数字表法将医院2011年5月至2013年12月收治的80例,美国麻醉医师协会（ASA）分级Ⅰ~Ⅱ级乳腺肿物切除术患者分为试验组和对照组,各40例。试验组采用瑞芬太尼复合咪达唑仑进行静脉麻醉,对照组采用氯胺酮复合咪达唑仑进行静脉麻醉,比较两组患者入手术室3 min（T1）、手术开始时（T2）、手术开始后5 min（T3）、手术开始后10 min（T4）、离开手术室前（T5）5个时间点的收缩压（SBP）、舒张压（DBP）、心率（HR）、脉搏血氧饱和度（Sp O2）、OAA/S镇静评分及不良反应发生率差异。结果各时刻Sp O2组间及组内比较均无显著变化。与T1时刻比较,试验组患者T2的SBP,DBP,HR显著下降（P〈0.05）;T3,T4比T1无显著性差异;对照组SBP,DBP,HR在T2及T5时无显著变化（P〉0.05）,但在T3及T4时明显升高。组间比较,在T2,T3,T4时,对照组的SBP,DBP,HR显著高于试验组（P〈0.05）。两组的呼吸抑制、术后诉疼痛、恶心呕吐发生率差异不显著（P〉0.05）;试验组的高血压发生率为2.50%,术后烦躁发生率为2.50%,均显著低于对照组的15.00%及20.00%。结论与传统的氯胺酮复合咪达唑仑比较,瑞芬太尼复合咪达唑仑用于原发性高血压行乳腺肿物切除术患者术中麻醉,术中高血压出现少,同时术后苏醒迅速,烦躁的发生率较低,具有更好的麻醉效果。Objective To investigate the anesthesia effect and safety of remifentanil combined with midazolam in primary hypertension patients undergoing breast tumor resection. Methods According to the random number table method, 80 cases of grade ASA Ⅰ-Ⅱ breast tumor resection in the hospital from May 2011 to December 2013 were divided into the experimental group and the control group with40 cases each. The experimental group adopted the intravenous anesthesia of remifentanil and midazolam anesthesia, while the control group adopted ketamine combined with midazolam for conducting intravenous anesthesia. The differences in the mean arterial pressure（ MAP）, systolic blood pressure（ SBP）, diastolic blood pressure（ DBP）, heart rate（ HR）, oxygen saturation（ Sp O2）, OAA / S sedation score and occurrence rate of adverse reactions at 3 min after entering the operation room（ T1）,operation beginning（ T2）,at 5 min after operation beginning（ T3）,10 min after operation beginning（ T4）, before leaving the operation room（ T5） were compared between the two groups. Results Sp O2 at each time point had no obvious change in inter-group and intra-group. SBP,DBP and HR at T2 in the experimental group were significantly decreased than those at T1（ P 0. 05）,which at T3,T4 and T5 had no significant differences compared with those at T1; SBP,DBP and HR at T2,T5 had no significant change compared with those at T1（ P 0. 05）,but which at T3,T4 were obviously increased compared with those at T1. SBP,DBP and HR at T2,T3,T4 in the control group were significantly higher than those in the experimental group（ P 0. 05）. The occurrence rates of respiratory depression, postoperative pain, vomiting and nausea had no significant differences between the two groups（ P 0. 05）. The occurrence rates of hypertension and postoperative agitation in the experimental group were 2. 50% and 2. 50% respectively,which were significantly lower than 15. 00% and 20. 00% in the control group. Conclusion Compared with tr

关 键 词：咪达唑仑 瑞芬太尼 氯胺酮 乳腺肿物切除术 原发性高血压 

分 类 号：R971.2[医药卫生—药品]