右美托咪定改善重症肌无力患者的血流动力学和苏醒质量  

Hemodynamics and recovery quality improved by dexmedetomidine for patients with myasthenia gravis

作　　者：梁维[1] 梁萌[1] 黄志华[1] 王华[1] 

机构地区：[1]桂林医学院附属医院麻醉科,广西桂林541001

出　　处：《华夏医学》2017年第1期54-57,共4页Acta Medicinae Sinica

摘　　要：目的:探讨右美托咪定对重症肌无力患者手术时全麻的血流动力学及术后苏醒质量的影响。方法:择期在全麻下行胸腺扩大切除术的患者70例,随机分为实验组和对照组,每组各35例。两组患者均采用常规全麻,实验组给予静脉泵入右美托咪定0.4μg·kg^(-1)·h^(-1),对照组给予相等量的生理盐水泵入。分别观察注药前(T1)、气管插管时(T2)、切皮时(T3)、开胸时(T4)、拔管时(T5)等各个时段血压(MAP)、心率(HR),以及术中麻药用量和苏醒时间、Steward苏醒评分。结果:实验组T2~T5的血压、心率比对照组低,且比实验组T1时也低,差异有统计学意义(P<0.05);实验组患者的七氟醚、丙泊酚以及芬太尼的用量比对照组明显减少,差异有统计学意义(P<0.01)。实验组患者苏醒质量明显优于对照组。结论:右美托咪定提高重症肌无力患者手术全麻效果,麻醉药用量少,复苏质量高。Objective：To explore the effects of dexmedetomidine on hemodynamics and recovery quality after general anesthesia of surgical operation on patients with myasthenia gravis.Methods：70 cases of patients undergoing enlarged thymus surgery under general anesthesia were randomly divided into experimental group and control group,each group had a total of 35 cases.Two groups of patients were treated with conventional general anesthesia,the experimental group was given intravenous infusion of dexmedetomidine 0.4 μg·kg-1·h-1,the control group was given the same amount of saline by the pump.The blood pressure（MAP）,heart rate（HR）,intraoperative anesthetic dosage and recovery time,Steward awakening score were observed respectively at the time of before injection（T1）,tracheal intubation（T2）,skin incision（T3）,open chest（T4）,extubation（T5）.Results：The blood pressure and heart rate of T2 T5 in experimental group were lower than those in the control group,and lower than those of T1 in the experimental group,the differences were statistically significant（P〈 0.05）; The amount of sevoflurane,propofol and fentanyl in the experimental group were significantly lower than those in the control group,the difference was statistically significant（P 〈 0.01）.The recovery quality of the experimental group was significantly better than that of the control group.Conclusion：Dexmedetomidine can improve the effect of general anesthesia in patients with myasthenia gravis,less anesthetic dosage,high recovery quality.

关 键 词：右美托咪定 重症肌无力 血流动力学 苏醒质量 

分 类 号：R730.2[医药卫生—肿瘤] R739.41[医药卫生—临床医学]