右美托咪定对重度子痫前期剖宫产患者拔管后恢复效果影响分析  

Influence of dexmedetomidine on recovery after extubation during cesarean section in patients with severe pre-eclampsia

作　　者：郭文斌 杨庆耿[2] 

机构地区：[1]惠州市第一妇幼保健院手术室,广东惠州516000 [2]惠州市中心人民医院麻醉科,广东惠州516001

出　　处：《中华实用诊断与治疗杂志》2016年第2期203-205,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：惠州市科技计划项目(2015Y083)

摘　　要：目的探讨重度子痫前期行剖宫产患者应用右美托咪定对拔管后恢复效果的影响。方法重度子痫前期行剖宫产患者128例，随机分为观察组和对照组各64例，观察组拔管后即刻静脉泵注右美托咪定0．2μg／（kg·h）；对照组拔管后即刻静脉注射质量分数25％硫酸镁20mL，5～10min注射完毕，之后以1～2g／h速率静脉滴注质量分数25％硫酸镁溶液60mL＋质量分数5％葡萄糖注射液500mL。比较2组拔管后6、12、24h镇痛有效率；用药后48h心率、血压；住院时间、咳嗽消失时间、喘憋与肺部湿啰音消失时间及并发症发生率。结果观察组拔管后6、12、24h镇痛有效率分别为87．5％、93．75％、98．44％，均明显高于对照组（43．75％、62．50％、42．18％）（P〈0．05）；观察组用药后48h心率[（90．3±11．9）次／min]、收缩压[（129±19）mmHg]、舒张压[（83±13）mmHg]低于对照组[（94．2±10．3）次／rain、（139±23）mmHg、（102±21）mmHg]（P〈0．05）；观察组住院时间[（33．40±8．79）d]、咳嗽消失时间[（5．76±1．34）d]、喘憋消失时间[（3．13±0．65）d]、肺部湿哕音消失时间[（5．83±1．32）d]均低于对照组[（47．50±9．52）d、（7．74±2．36）d、（4．58±0．87）d、（7．58±2．61）d]（P〈0．05）；观察组低血压、心动过缓、瘙痒及恶心呕吐发生率与对照组比较差异无统计学意义（P〉0．05）。结论重度子痫前期行剖宫产患者应用右美托咪定可有效镇痛，改善患者心率、血压，缩短症状改善时间及住院时间。Objective To explore the influence of dexmedetomidine on the recovery after extubation during cesarean section in patients with severe pre-eclampsia. Methods A total of 128 severe pre-eclampsia patients undergoing cesarean section were randomly divided into observation group and control group, with 64 patients in each group. Observation group was intravenously pumped dexmedetomidine 0.2 μg/（kg · h） immediately after extubation, and control group was intravenously injected 25% magnesium sulfate 20 mL within 5 to 10 minutes followed by intravenous injection of 25% magnesium sulfate 60 mL in 5 % glucose injection 500 mL at the speed of 1 to 2 g/h. The analgesia effective rates in 6, 12 and 24 hours after extubation, the heart rate and blood pressure in 48 hours after treatment, hospitalization stay, the fading time of cough, wheezes, crackles and rale, and the incidence of complications were observed and compared between two groups. Results The analgesic effective rates were 87. 5%, 93. 75% and 98. 44% in 6, 12 and 24 hours after extubation in observation group, significantly higher than those in control group （43.75%, 62.50%, 42.18%） （P〈 0.05）. The heart rate （（90. 3±11. 9） beats/rain）, systolic blood pressure （（129 ± 9） mm Hg） and diastolic blood pressure （（83±13） mm Hg） in observation group were significantly lower than those in control group （（94.2± 10.3） beats/min, （139±23） mm Hg, （102±21） mm Hg） （P〈0.05）. The hospitalization stay （（33. 40±8.79） days）, fading time of cough （（5.76±1.34） days）, %ading time of wheezes （（3.13±0.65） days） and the fading time of crackles and rale （（5.83±1. 32） days） in observation group were significantly shorter than those in control group （（47. 5±9. 52）,（7.74±2.36）, （4.58±0.87）, （7.58±2.61） days） （P〈0.05）. There were no significant differences in the incidences of complications including hypotension, bradycardia, itching, nausea and vomiting between

关 键 词：妊娠高血压 重度子痫前期 右美托咪定 硫酸镁 

分 类 号：R614[医药卫生—麻醉学]