右美托咪定对老年2型糖尿病患者全麻气管插管期心血管反应的影响  

Influence of dexmedetomidine on cardiovascular reaction of senile type 2 diabetic mellitus patients during tracheal intubation general anesthesia

作　　者：谢淑芬[1] 谢海辉[1] 张曙[1] 王杰荣 

机构地区：[1]广东省东莞市人民医院麻醉科,523000

出　　处：《中国实用医药》2017年第8期117-119,共3页China Practical Medicine

摘　　要：目的探讨静脉注射盐酸右美托咪定对老年2型糖尿病患者全身麻醉(全麻)气管插管期心血管反应的影响。方法 82例择期行中上腹部手术的老年2型糖尿病患者,随机分成D组和C组,各41例。D组行盐酸右美托咪定静脉注射麻醉诱导,C组行等容量氯化钠(NaCl)溶液静脉注射空白对照,记录并比较麻醉前后不同时刻的QTc间期、血压及心率(HR)变化。结果麻醉诱导后1 min(T_1)、3 min(T_2),两组收缩压(SBP)、舒张压(DBP)较麻醉诱导前(T_0)稍降低,且D组SBP和DBP降低幅度大于C组,差异有统计学意义(P<0.05);插管后30 s(T_3)、3 min(T_4),两组HR、SBP和DBP较T0均显著升高,且D组HR、SBP及DBP小于C组,差异有统计学意义(P<0.05),D组QTc间期与T0比较差异无统计学意义(P>0.05),C组延长且明显长于D组,差异有统计学意义(P<0.05)。气管插管后C组QTc间期延长并>440 ms者11例(26.8%),明显多于D组的2例(4.9%),差异有统计学意义(P<0.05)。结论静脉注射右美托咪定能明显抑制老年2型糖尿病患者因全麻诱导围气管插管期导致的QTc间期延长,能一定程度抑制插管引起的心血管应激反应,维持血流动力学平稳。Objective To explore the influence of intravenous injection of dexmedetomidine hydroch on cardiovascular reaction of senile type 2 diabetic mellitus patients during tracheal intubation general anesthesia. Methods A total of 82 senile type 2 diabetic mellitus patients with upper abdominal surgery were randomly divided into group D and group C, with 41 cases in each group. Group D received intravenous injection of dexmedetomidine hydroch for anesthesia induction, and group C received equal volume of sodium chloride（NaCl） solution by intravenous injection as blank control. Record and comparison were made on QTc interphase, blood pressure and heart rate（HR） changes at different time before and after anesthesia in two groups. Results At 1 min（T1） and 3 min（T2） after anesthesia induction, both groups had a little lower systolic blood pressure（SBP） and diastolic blood pressure（DBP） than before anesthesia（T_0）, and group D had higher decline range than group C. Their difference had statistical significance（P〈0.05）. At 30s（T3） and 3 min（T4） after intubation, both groups had obviously higher HR, SBP and DBP than T_0, and group D had lower HR, SBP and DBP than group C. Their difference had statistical significance（P〈0.05）. Group D had no statistically significant difference in QTc interphase comparing with T_0（P〉0.05）. Group C had prolonged QTc interphase, and it was obviously longer than group D. Their difference had statistical significance（P〈0.05）. Group C had 11 prolonged QTc interphase 〉440 ms cases（26.8%） after tracheal intubation than 2 cases（4.9%） in group D, and their difference had statistical significance（P〈0.05）. Conclusion Intravenous injection of dexmedetomidine can clearly inhibit prolonged QTc interphase in senile type 2 diabetic mellitus patients caused by tracheal intubation general anesthesia. It also can control intubation induced cardiovascular stress reaction to a certain extent and maintain stable hemodynamics.

关 键 词：右美托咪定 老年2型糖尿病 气管插管 QTC间期 

分 类 号：R614.2[医药卫生—麻醉学]