右旋美托咪定对胸腰椎骨折全身麻醉患者围拔管期血流动力学的影响  

Hemodynamics of period of tracheal extubation and recovery process of dexmedetomidine to general anesthesia patients with thoracolumbar fracture

作　　者：龚清安[1] 李熳[2] 

机构地区：[1]河南省南阳市中心医院麻醉科,473009 [2]华中科技大学同济医学院神经生物学系,武汉430030

出　　处：《重庆医学》2015年第29期4083-4085,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81473768);教育部留学回国人员科研启动基金资助项目(2008890)

摘　　要：目的研究右旋美托咪定对胸腰椎骨折手术全身麻醉患者围拔管期血流动力学及苏醒过程的影响。方法选择2011年5月至2014年5月在南阳市中心医院接受手术治疗的胸腰椎骨折患者90例作为研究对象。根据随机数字表法随机分成对照组(生理盐水)、0.5μg右美托咪定组以及1.0μg右美托咪定组。分析右美托咪定剂量与血流动力学指标及苏醒过程相关指标的相关性。结果各组患者不同时间的SBP、DBP及HR水平在组内相比,差异有统计学意义(P<0.05)。0.5μg右美托咪定组及1.0μg右美托咪定组在T2时的SBP及DBP水平均分别显著高于T0时的水平,HR水平显著低于T0时的水平,差异均有统计学意义(P<0.05)。但3组间的SBP、DBP及HR水平相比,差异无统计学意义(P>0.05)。1.0μg右美托咪定组的苏醒时间及拔管时间均显著大于对照组及0.5μg右美托咪定组,OAA/S评分与躁动评分均显著小于对照组及0.5μg右美托咪定组,差异均有统计学意义(P<0.05)。右美托咪定剂量与SBP、DBP及HR无明显相关性,但与苏醒时间及拔管时间呈正相关,与OAA/S评分及躁动评分呈负相关。结论右美托咪定应用在胸腰椎骨折手术的全麻过程中,选择剂量为0.5μg能够较好地稳定患者在围拔管期的血流动力学指标,改善其苏醒过程,效果较好。Objective To study hemodynamics of period of tracheal extubation and recovery process of Dexmedetomidine to general anesthesia patients with thoracolumbar fracture.Methods Totally 90 cases of patients as the research object of thoracolumbar fracture from May 2011 to May 2014 in our hospital to accept operation treatment.According to the figures were randomly divided into control group（saline）,0.5μg dexmedetomidine group and 1.0μg dexmedetomidine group.Results Each group of patients with different time of SBP,DBP and HR levels compared to within the group,the difference was statistically significant（P〈0.05）.0.5μg dexmedetomidine group and 1.0μg dexmedetomidine SBP and DBP levels in T2 group were significantly higher than the level of T0,HR level was significantly lower than the level of T0,the difference was statistically significant（P〈0.05）.But among the three groups of SBP,DBP and HR levels compared,had no significant difference（P〉0.05）.Recovery time and pull 1.0μg dexmedetomidine group were significantly higher than the control group time and 0.5μg dexmedetomidine group,OAA/S score and agitation scores were significantly lower than control group and 0.5μg dexmedetomidine group,the difference was statistically significant（P〈0.05）.According to correlation analysis showed that Spearman method,dexmedetomidine dose and SBP,DBP and HR had no significant correlation,but with the recovery time and extubation time was positively correlated with the OAA/S score,and the agitation score was negatively related to.Conclusion General anesthesia during the application of dexmedetomidine in thoracic and lumbar fracture operation in the selection,dose of 0.5μg can better stability in patients with hemodynamic index tube period pull wall,improve the recovery process,the effect is good.

关 键 词：脊柱骨折 胸椎 腰椎 麻醉药 全身 右旋美托咪定 围拔管期 血流动力学 苏醒过程 

分 类 号：R614[医药卫生—麻醉学]