右美托咪定复合尼卡地平用于鼻内镜手术控制性降压临床研究  

Dexmedetomidine Combined with Nicardipine in Controlled Hypotension of Nasal Endoscopic Surgery

作　　者：张红芹[1] 郑静[1] 徐璐[1] 江春秀[1] 

机构地区：[1]重庆市第三人民医院,重庆400014

出　　处：《中国药业》2016年第7期33-35,共3页China Pharmaceuticals

摘　　要：目的探讨右美托咪定复合尼卡地平应用于鼻内镜手术中对控制性降压的影响。方法选择医院收治的40例择期鼻内镜手术患者,随机分为尼卡地平组(N组)和右美托咪定复合尼卡地平组(YN组),各20例。观察降压前(T0),开始降压后10 min(T1)、20 min(T2)、30 min(T3),降压结束(T4),降压结束后10 min(T5)的平均动脉压(MAP)、心率(HR)、血乳酸值(Lac),记录手术时间、拔管时间及尼卡地平总用量、术中出血量、术野质量评分、MAP恢复时间。结果降压后与T0组比较:N组T1至T5血压明显下降(P<0.05),YN组T1至T4血压明显下降(P<0.05);N组T1至T5心率明显升高(P<0.05),YN组T1心率减慢(P<0.05);Lac YN组和N组T2至T5升高(P<0.05)。YN组T1,T5血压较N组升高(P<0.05),YN组T1到T5心率较N组降低(P<0.05);YN组T4,T5 Lac较N组下降(P<0.05)。2组手术时间、拔管时间差异无统计学意义(P>0.05);YN组出血量较N组明显减少,术野质量评分低(P<0.05);YN组尼卡地平用量较N组明显减少(P<0.05);YN组MAP恢复时间较N组明显缩短(P<0.05)。结论盐酸右美托咪定与尼卡地平联合使用可有效降低不良反应发生情况,减少术中出血量,不影响重要器官灌注,提高了围术期安全性,值得临床推广。Objective To study the efficacy of dexmedetomidine combined with nicardipine on the controlled hypotension in nasal endoscopic surgery. Methods 40 cases of hospitalized patients waiting for nasal endoscopic surgery were randomly divided into 2 groups：nicardipine group（ group N, n = 20） and dexmedetomidine combined with nicardipine group（ group YN, n = 20）. The MAP,HR and the blood lactic acid value（ LAC） were monitored before the hypotension（ T0）,10 min（ T1）,20 min（ T2） and 30 min（ T3） after the hypotension,the end of hypotension（ T4） and the 10 minutes after the end of hypotension（ T5）,and the operation time,extubation time,the dosage of nicardipine, intraoperative blood loss, the surgical field quality score and the MAP recovery time were recorded respectively. Results Compared with group T0,the blood pressure of T1- T5 in group N and T1- T4 in group YN decreased significantly（ P〈0. 05）; the heart rate of T1 ~ T5 in group N increased significantly（ P〈0. 05）,the heart rate of T1 in group N slowed down significantly（ P〈0. 05）; The value of LAC of T2- T5 in group N and group YN increased significantly（ P〈0. 05）; The blood pressure of T1 and T5 in group YN was higher than that of group N（ P〈0. 05）,the heart rate of T1 ~ T5 in group YN was lower than that of group N（ P〈0. 05）; The value of LAC of T4 and T5 in group YN was lower than that of group N（ P〈0. 05）. Between 2 groups,the operation time and extubation time had no significant difference. Compared with group N,the blood loss,the surgical field quality score,the dosage of nicardipine decreased significantly,and the MAP recovery time of group YN was shorter than that of group N significantly. Conclusion Dexmedetomidine combined with nicardipine can effectively reduce their own adverse reaction,and reduce the amount of bleeding,does not affect the perfusion of vital organs,and improve the perioperative safety.

关 键 词：右美托咪定 尼卡地平 控制性降压 鼻内镜术 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]