右美托咪定在急性冠脉综合征患者诱导期及维持的应用  

Application of Dexmedetomidine in the induction and maintenance of patients with acute coronary syndrome

作　　者：郑海涛[1] 苏新娟[1] 胡杰[1] 

机构地区：[1]郑州大学附属洛阳中心医院麻醉科,河南洛阳471000

出　　处：《中国当代医药》2016年第33期120-122,共3页China Modern Medicine

基　　金：河南省洛阳市科技局基金项目(1503006A-2)

摘　　要：目的 探讨右美托咪定用于急性冠脉综合征患者诱导期的安全性及应激反应的影响。方法 选取2015年1~12月在我院进行手术治疗的急性冠脉综合征患者25例为试验组,选取2014年1~12月急性冠脉综合征手术患者20例作为对照组,试验组15 min泵注右美托咪定1μg/kg,后按0.3μg/（kg·h）持续泵注,对照组15 min泵注等量生理盐水,然后依托咪酯、舒芬太尼、维库溴铵缓慢诱导插管,靶控输注丙泊酚和舒芬太尼维持,脑电双频指数（BIS）值保持在40~60。于T1（麻醉诱导后）、T2（吻合前降支）、T3（术后1 h）、T4（术后48 h）记录血压和心率,采血3ml检测皮质醇浓度。结果 试验组皮质醇浓度在T3、T4都明显低于对照组,且试验组在T1、T2、T3点比对照组心率慢（P〈0.05）。结论 右美托咪定对急性冠脉综合征患者诱导和维持,循环更稳定,更有效的抑制心肌应激反应。Objective To explore the safety and the effects of Dexmedetomidine on acute coronary syndrome patients during induction.Methods 25 patients with acute coronary syndromes who underwent surgery in our hospital from Jan- uary to December 2015 were selected as experimental group,20 patients with acute coronary syndromes from January to December 2014 were selected as control group.The patients in the experimental group were injected with 1 μg/kg Dexmedetomidine for 15 minutes and then injected with 0.3 μg/kg＇h of the same volume of saline for 15 minutes,then Etomidate,Sufentanil,Vecuronium slowly induced intubation.Propofol and sufentanil were maintained by target-con- trolled infusion, and bispectral index （BIS） was maintained at 40 to 60.Blood pressure and heart rate were recorded at Tj,T2,T3,and T4.Cortisol concentration was measured by 3 ml blood collection.Results The concentration of cortisol in experimental group was significantly lower than that of control group at T3 and T4,and the heart rate at TI,T2 and T3 was slower than that of control group （P〈0.05）.Conclusion Dexmedetomidine can induce and maintain acute coronary syn- drome,and the circulation is more stable and more effective in suppressing myocardial stress response.

关 键 词：右美托咪定 冠脉综合征 诱导期 

分 类 号：R971.2[医药卫生—药品]