冠心病冠状动脉搭桥术联合右美托咪定靶控输注对冠心病疗效及HR、MAP、RPP的影响  

Effects of Coronary Artery Bypass Grafting and Target-controlled Infusion of Dexmedetomidine on HR,MAP,RPP in Coronary Heart Disease

作　　者：杜守峰[1] 师文华[1] 孙君隽[1] 

机构地区：[1]河南省南阳市中心医院,河南南阳473009

出　　处：《中西医结合心脑血管病杂志》2017年第18期2290-2293,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨冠心病冠状动脉搭桥术联合右美托咪定靶控输注对冠心病疗效及心率(HR)、平均动脉血压(MAP)、HR乘积(RPP)的影响。方法选择2016年1月—2016年12月我院接诊的80例冠心病病人,按随机数字表法分为观察组和对照组,各40例。两组均进行冠心病冠状动脉搭桥术,观察组手术基础上联合右美托咪定进行治疗。比较麻醉前、麻醉后、插管前、插管后及插管后5min时两组病人的心率、收缩压(SBP)、舒张压(DBP)、平均动脉血压及SBP与HR乘积水平。结果观察组在插管后及插管后5min时HR水平均低于对照组[(70.38±6.44)次vs(73.67±6.54)次,(76.95±3.59)次vs(78.89±3.43)次](P<0.05);观察组在插管后SBP、DBP和MAP水平均低于对照组[(102.53±5.99)mmHg vs(117.64±6.28)mmHg,(66.82±4.81)mmHg vs(69.29±4.53)mmHg,(73.23±6.89)mmHg vs(76.33±4.99)mmHg](P<0.05);观察组在插管后5min SBP、DBP和MAP水平均低于对照组[(115.99±6.62)mmHg vs(119.98±5.39)mmHg,(69.99±5.83)mmHg vs(72.72±4.51)mmHg,(82.43±4.59)mmHg vs(84.72±3.81)mmHg](P<0.05);观察组在插管后及插管后5min时其RPP值和对照组相比降低更为明显[(10798.53±1399.79)次/(min·mmHg)vs(11548.89±1 439.73)次/(min·mmHg),(12 454.92±1 032.41)次/(min·mmHg)vs次/(12 994.83±1 035.89)(min·mmHg)](P<0.05)。结论冠状动脉搭桥术治疗冠心病中采用右美托咪定进行靶控输注,可有效减轻病人在术中的心肌耗氧和气管插管时心血管反应,提高手术成功率,减轻痛苦。Objective To study application of coronary artery bypass grafting（CABG）and target-controlled infusion of dexmedetomidine on heart rate（HR）,mean arterial pressure（MAP）,and rate pressure product（RPP）in coronary heart disease（CHD）.Methods Eighty patients with CHD who received therapy from January 2016 to December 2016 were selected and randomly divided into two groups：control group（n =40）treated with CABG,and observation group（n =40）treated with CABG and target-controlled infusion of dexmedetomidine.The levels of HR,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,MAP and RPP were compared.Results HR levels were lower in observation group than that in control group after intubation and 5 min after intubation[（70.38±6.44）vs（73.67±6.54）,（76.95±3.59）vs（78.89±3.43）,all P 0.05].The levels of SBP,DBP and MAP in observation group were lower than that in control group after intubation [（102.53±5.99）mmHg vs.（117.64±6.28）mmHg,（66.82±4.81）mmHg vs.（69.29±4.53）mmHg,（73.23±6.89）mmHg vs.（76.33±4.99）mmHg,all P 0.05].The levels of SBP,DBP and MAP in observation group were lower than those in control group at 5 min after intubation[（115.99±6.62）mmHg vs.（119.98±5.39）mmHg,（69.99±5.83）mmHg vs（72.72±4.51）mmHg,（82.43±4.59）mmHg vs（84.72±3.81）mmHg,all P 0.05].The RPP values were significantly lower in observation group than those in control group at 5 min after intubation and intubation [（10798.53±1 399.79）/（min·mmHg）vs（11 548.89±1 439.73）/（min·mmHg）,（12 454.92±1 032.41）/（min·mmHg）vs（12 994.83±1035.89）/（min·mmHg）,all P 0.05].Conclusion CABG and target-controlled infusion of dexmedetomidine can effectively reduce the intraoperative myocardial oxygen consumption and the cardiovascular response during the tracheal intubation,improve the success rate of operation and relieve the pain in patient with CHD.

关 键 词：冠心病 右美托咪定 冠状动脉搭桥术 应激反应 

分 类 号：R614[医药卫生—麻醉学]