右美托咪定复合舒芬太尼在颈椎骨折清醒状态下行气管插管患者中的应用效果  

Effect of dexmedetomidine combined with sufentanil in patients with cervical spine fracture under conscious state of tracheal intubation

作　　者：张琦[1] 吕洁[1] 巨长桥[1] 崔洋[1] ZHANG Qi, LV Jie, JU Changqiao, CUI Yang(Department of Anesthesiology, the Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang 157000, China)

机构地区：[1]牡丹江医学院第二附属医院麻醉科,黑龙江牡丹江157000

出　　处：《中国医药科学》2018年第15期142-144,162,共4页China Medicine And Pharmacy

摘　　要：目的探讨右美托咪定复合舒芬太尼在颈椎骨折清醒状态下行气管插管患者中的应用效果,旨在为临床治疗颈椎骨折患者提供相应的意见和建议。方法选取2014年12月~2016年1月期间被我院诊断为颈椎骨折的患者30例,采取随机数字表法将患者随机分成对照组和实验组;在手术前8h禁食、4h禁水,所有患者术前均不用药,入室后建立静脉通路,对照组采用静脉注射舒芬太尼;实验组组先静脉输注右美托咪定,负荷量0.6μg/kg(10min),再以每小时0.3μg/kg维持,经鼻气管插管后3min时静脉注射舒芬太尼0.5μg/kg,观察比较两组患者的MAP、HR、Sp O2数据、血浆肾上腺素(E)和去甲肾上腺素(NE)水平及两组患者的耐受程度。结果实验组和对照组患者在插管3min后的血浆肾上腺素(E)和去甲肾上腺素(NE)比较,实验组皆高于对照组,差异有统计学意义(P<0.05);实验组患者在插管时和插管后的耐受得分高于对照组,差异有统计学意义(P<0.05)。结论右美托咪定复合舒芬太尼在颈椎骨折清醒状态下行气管插管患者中的应用效果显著,患者的耐受性较好,应激反应减轻血流动力学平稳。Objective To explore the application effect of dexmedetomidine combined with sufentanil in patients with cervical spine fracture under conscious state of tracheal intubation, so as to provide corresponding opinions and suggestions for clinical treatment of cervical spine fracture patients. Methods From December 2014 to January 2016, 30 patients with diagnosis of cervical spine fracture in our hospital were selected, and were randomly divided into control group and experimental group by random number table. Fasting for 8 hours, water was prohibited 4 hours before surgery. All patients were given no drugs before operation, and a venous access was established after entering the operating room. The control group was injected intravenously with sufentanil. In the experimental group, dexmedetomidine was given intravenously at a dose of 0.6μg/kg（10 minutes） and then maintained at 0.3μg/kg per hour, sufentanil was given intravenously at 3 minutes after nasotracheal intubation. The data of MAP, HR, Sp O2, plasma levels of epinephrine（E）, norepinephrine（NE） and tolerance of the two groups were compared. Results The plasma levels of epinephrine（E） and norepinephrine（NE） 3 minutes after intubation in the experimental group were significantly higher than those in the control group（P〈0.05）. The tolerance score of experimental group was higher than that of control group at intubation and after intubation（P〈0.05）. Conclusion The application of dexmedetomidine combined with sufentanil in patients with cervical spine fracture under conscious state of tracheal intubation has a significant effect. The patients are well tolerated and stress response reduces hemodynamic stability.

关 键 词：右美托咪定 舒芬太尼 颈椎骨折 气管插管 应用效果 

分 类 号：R614[医药卫生—麻醉学]