持续泵注右美托咪定对双腔管置入患者苏醒期心血管反应的影响  

Cardiovascular influence of continue pumped dexmedetomidine in double -lumen tube inserted patients

作　　者：韩利锋[1,2] 高静[2] 李雷[1] 张少博[1] 高彦东[2] 郭宇峰[2] 边步荣[2] 张蓬勃[1] 

机构地区：[1]榆林市第一医院麻醉科,陕西省榆林719000 [2]西安交通大学第二附属医院麻醉科,陕西省西安710004

出　　处：《中国基层医药》2016年第13期2035-2039,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：观察持续泵注右美托咪定对双腔管置入开胸患者拔管时血流动力学、苏醒质量、应激反应的影响。方法选择开胸手术患者60例，采用数字表法随机分为0．9％氯化钠注射液组（N 组，n ＝30）、右美托咪定组（D 组，n ＝30），两组诱导前20 min 分别持续泵注0．9％氯化钠注射液、右美托咪定，分别记录术中两组各时间点的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2），T0与 T3时间抽取动脉血5 mL，离心冻存检测肾上素水平。记录拔管时间、苏醒期躁动发生率、定向力恢复时间、拔管质量评分。结果D 组 T0、T1、T2、T3、T4时间点 MAP 分别为（97±15）mmHg、（102±12）mmHg、（103±11）mmHg、（98±12）mmHg、（96±13）mmHg，HR 分别为（69±9）次／min、（80±6）次／min、（90±7）次／min、（74±5）次／min、（73±6）次／min， SpO2分别为（95±3）％、（98±2）％、（98±2）％、（95±3）％、（96±2）％；N 组 T0、T1、T2、T3、T4时间点 MAP分别为（96±15）mmHg、（112±16）mmHg、（120±12）mmHg、（117±14）mmHg、（102±15）mmHg，HR 分别为（68±7）次／min、（84±8）次／min、（105±6）次／min、（89±6）次／min、（80±7）次／min，SpO2分别为（96±2）％、（98±2）％、（97±3）％、（93±3）％、（92±4）％；D 组不同时间 MAP、HR、SpO2显著低于 N 组，差异均有统计学意义（MAP：tT1＝2．74、tT2＝5．72、tT3＝25．63、tT4＝1．66，均 P ＜0．05；HR：tT1＝2．20、tT2＝8．91、tT3＝10．52、tT4＝4．16，均 P ＜0．05；SpO2：tT1＝0．00、tT2＝1．52、tT3＝2．58、tT4＝4．9，PT3＜0．05、PT4＜0．05）。D 组定向力恢复时间、躁动评分、拔管质量评分分别为（3．3±2．2）min、（1．3±0．9）分、（2．1±1．2）分，N 组分别为（5．2±2.3）min、（2．4±1．2）分、（3．2±1．4）分，两组差异均有统计学意义（t ＝3．27、Objective To observe the effect of continuous pumped dexmedetomidine on hemodynamics, awakening quality and stress response in double -lumen tube extubation patients.Methods 60 patients with thoracic surgery were divided into saline group（group N,n =30）and Dex group（group D,n =30）.Both two groups were continuously pumped NS and dexmedetomidine respectively 20min before anesthesia.MAP,HR and SpO2 at different time points during the surgery were recorded.Extracted 5ml arterial blood at the time point of T0 and T3,centrifugated and stored at -80 ℃ for testing renin levels.The extubation time,restlessness incidence,orientation recovery time, extubation quality score were recorded.Results The values of MAP in group D at time points of T0,T1,T2,T3,T4 were （97 ±15）mmHg,（102 ±12）mmHg,（103 ±11）mmHg,（98 ±12）mmHg,（96 ±13）mmHg.The values of HR in group D at different time points were （69 ±9）times/min,（80 ±6）times/min,（90 ±7）times/min,（74 ±5）times/min,（73 ±6）times/min.The values of SpO2 in group D at different time points were （95 ±3）%,（98 ±2）%,（98 ± 2）%,（95 ±3）%,（96 ±2）%.The values of MAP in group N at time points of T0,T1,T2,T3,T4 were （96 ± 15）mmHg,（112 ±16）mmHg,（120 ±12）mmHg,（117 ±14）mmHg,（102 ±15）mmHg.The values of HR in group N at different time points were （68 ±7）times/min,（84 ±8）times/min,（105 ±6）times/min,（89 ±6）times/min, （80 ±7）times/min.The values of SpO2 in group N at different time points were （96 ±2）%,（98 ±2）%,（97 ± 3）%,（93 ±3）%,（92 ±4）%.The values of MAP,HR,SpO2 at different time points in group D were significantly lower than those in group N,the differences were statistically significant （the t values of MAP at different time points were tT1 =2.74,tT2 =5.72,tT3 =25.63,tT4 =1.66,all P 〈0.05;the t values of HR at different time points were tT1 =2.20,tT2 =8.91,tT3 =10.52,tT4 =4.16,all P 〈0.05;the t values of SpO2 at different time points were tT1 =

关 键 词：右美托咪定 苏醒期 心血管反应 肾上腺素 

分 类 号：R614[医药卫生—麻醉学]