右美托咪定对急性梗阻性化脓性胆管炎手术的血流动力学及麻醉苏醒期的影响  

Effect of dexmedetomidine on the hemodynamics and anesthesia recovery period in the patients with acute obstructive suppurative cholangitis

作　　者：梁敏[1] 李运繁 何文明[1] 卢燕 

机构地区：[1]广东省廉江市人民医院麻醉科,广东廉江524400 [2]广东医科大学附属医院麻醉科,广东湛江524001

出　　处：《广东医科大学学报》2017年第1期59-62,共4页Journal of Guangdong Medical University

基　　金：湛江市科技攻关项目(No.2016B01020)

摘　　要：目的探讨右美托咪定(Dex)对急性梗阻性化脓性胆管炎(AOSC)手术患者的血流动力学及麻醉苏醒期的影响。方法将88例行AOSC患者随机分为观察组(44例)和对照组(44例),观察组从麻醉诱导开始到拔管给予0.40μg/(kg·h)的Dex泵入,对照组给予相同剂量生理盐水泵入。统计两组患者麻醉诱导前5 min(T0)、切皮时(T1)、手术开始后30 min(T2)、手术结束时(T3)和拔管完成时(T4)的血流动力学指标。评估两组的复苏期间镇静效果、舒适度和满意度,记录两组的不良反应。结果在T1、T2、T3和T4时,观察组的平均动脉压、心率和呼吸频率值均明显低于对照组(P<0.05);躁动、高血压和心率加快的发生率均低于对照组(P<0.05);舒适度为"优"的构成比明显高于对照组(P<0.05)。结论 Dex不但使AOSC手术患者的血流动力学更加平稳,而且可减少不良反应,同时有效改善患者的舒适度。Objective To investigate the effect of dexmedetomidine （Dex） on the hemodynamics and anesthesia recovery period in the patients with acute obstructive suppurative cholangitis （AOSC）. Methods 88 patients with AOSC were randomly divided into Observation Group （44 cases） and Control Group （44 cases）. Observation Group was given 0.40 g/ （kg·h） Dex by micro pump from anesthesia induction to extubation while Control Group was given the same dose of physiological saline by micro pump. The hemodynamic parameters of 2 groups 5min before anesthesia induction （T0）, skin cutting （T1）, 30min after operation （T2）, at the end of surgery （T3） and after extubation （T4） were measured. The sedative effect, comfort level and satisfaction of the two groups were evaluated during resuscitation. Adverse reactions of the two groups were recorded. Results The values of mean arterial pressure, heart rate and respiratory rate of Observation Group were significantly lower than those of Control Group at T1, T2, T3 and T4 （P〈0.05）. The incidence of restlessness, hypertension and accelerated heart rate in Observation Group were significantly lower than those in Control Group （P〈0.05）. The proportion of those with the comfort level of excellent in Observation Group was higher than that in Control Group （P〈0.05）. Conclusions Dex can not only facilitate a more stable hemodynamics in AOSC surgery, but also reduce adverse reactions and effectively improve the comfort of the patient.

关 键 词：右美托咪定 急性梗阻性化脓性胆管炎 血流动力学 麻醉苏醒期 

分 类 号：R614[医药卫生—麻醉学]