右美托咪定在高龄高血压患者双极等离子体前列腺切除术中的应用效果分析  

Clinical application of dexmedetomidine in elderly hypertensive patients with bipolar plasma resection of the prostate

作　　者：曹薇薇[1] 

机构地区：[1]沈阳市第五人民医院麻醉科,辽宁110023

出　　处：《社区医学杂志》2015年第21期28-30,共3页Journal Of Community Medicine

摘　　要：目的观察右美托咪定在高龄高血压患者中的镇静效果以及对患者血流动力学的影响。方法选择2014年1—10月收治的择期行双极等离子体前列腺切除术的高龄高血压患者60例作为研究对象,随机分为D组和C组各30例。联合阻滞麻醉操作完成后,D组持续静脉泵入右美托咪定,C组泵入等量生理盐水。观察并记录患者MAP、HR、RR、Sp O2等基本生命体征变化情况,同时监测麻醉/脑电意识检测系统麻醉趋势指数(Narcotrend index,NTI)以及观察者镇静警觉评分(observer’s assessment of alertness sedation,OAA/S)。计量资料组间比较采用t检验,组内比较采用重复测量资料的方差分析,两两比较采用LSD-t检验,P<0.05为差异有统计学意义。结果 C组给药时、给药后10、30、60 min及术毕时的MAP分别为(114.9±8.7)、(115.8±8.2)、(114.8±8.2)、(113.9±7.8)、(115.6±7.7)mm Hg(1 mm Hg=0.133 k Pa),均高于平素的(103.9±8.6)mm Hg,差异均有统计学意义(均P<0.05)。D组患者给药30、60 min及术毕时MAP分别为(103.1±8.2)、(99.0±6.9)、(102.6±7.7)mm Hg,均低于给药时的(115.4±8.1)mm Hg,差异均有统计学意义(均P<0.05)。两组给药10、30、60 min及术毕时MAP比较差异均有统计学意义(均P<0.05)。D组给药10、30、60 min及术毕时的NTI及OAA/S得分分别为(88.9±6.9)、(81.1±5.9)、(77.6±7.1)、(78.7±6.6)、(4.3±0.4)、(3.2±0.4)、(3.0±0.5)、(3.2±0.4)分,均低于给药时的(94.9±4.1)、(4.6±0.5)分,差异均有统计学意义(均P<0.05)。D组给药10、30、60 min及术毕时的NTI指数及OAA/S得分均低于C组的(92.4±6.2)、(87.8±6.2)、(85.8±7.4)、(88.4±5.4)、(4.5±0.6)、(4.2±0.4)、(4.1±0.7)、(4.1±0.5)分,差异均有统计学意义(均P<0.05)。结论右美托咪定应用于高龄高血压患者双极等离子体前列腺切除术可有效镇静,控制血压,使血流动力学更加平稳。Objective To observe the clam effects of dexmedetomidine in elderly hypertensive patients and the influence of hemodynamic Methods 60 elderly hypertension patients who were undergoing selective bipolar plasma resection of the prostate during January to October 2014 were randomly divided into group D and group C（n=30）.End of the eqidural block, patients in the group D received dexmedetomidine continuous intravenous, while saline was used in the group C.Observe and record the changes of MAP,HR,RR and Sp O2. Simultaneously monitoring the Narcotrend index（NTI）and observer＇s assessment of alertness/sedation score（OAA/S）.Measurement data between group was processed by t test, in group was processed by repeated measures ANOVA,between group pairwise comparison was preformed with LSD- t test,P〈0.05 was considered statistically significant.Results The MAP of giving the drug,after 10,30,60 mintues and the end of operation in group C were（114.9±8.7）,（115.8±8.2）,（114.8±8.2）,（113.9±7.8）,（115.6±7.7）mm Hg（1 mm Hg=0.133 k Pa）,lower than that before dosing[（103.9±8.6）mm Hg], the difference were statistically significant（all P〈0.05）.The MAP of giving the drug,after 30,60 minutes and end of operation in group D were（103.1±8.2）,（99.0±6.9）,（102.6±7.7）mm Hg,lower than that before dosing[（115.4±8.1）mm Hg], the differences were statistically significant（all P〈0.05）. There were significant differences between the two groups when giving the drug and after10,30,60 mintues,end of operation on MAP（all P〈0.05）. The NTI and OAA/S of group D when giving the drug after10,30,60 mintues and end of operation were（88.9±6.9）,（81.1±5.9）,（77.6±7.1）,（78.7±6.6）,（4.3±0.8）,（3.2±0.4）,（3.0±0.5）,（3.2±0.4）points,lower than that before dosing [（94.9±4.1）,（4.6±0.5）point], the differences were statistically significant（all P〈0.05）. The NTI and OAA/S in group D when giving the drug after 10,30,60 mintues,end of operation we

关 键 词：右美托咪定 高龄 高血压 双极等离子体前列腺切除术 

分 类 号：R453.9[医药卫生—治疗学]