右美托咪定注射液用于置入支气管阻塞器进行单肺通气患者的临床研究  

Clinical trial of dexmedetomidine injection in the treatment of patients with single lung ventilation with bronchial obstruction

作　　者：张志君[1] 牛志强[1] 郑孟良 ZHANG Zhi-jun;NIU Zhi-qiang;ZHENG Meng-liang(Department of Anesthesia,Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China)

机构地区：[1]沧州市中心医院麻醉科,河北沧州061000

出　　处：《中国临床药理学杂志》2018年第17期2055-2058,共4页The Chinese Journal of Clinical Pharmacology

基　　金：沧州市科技计划基金资助项目(151302063)

摘　　要：目的观察右美托咪定注射液用于置入支气管阻塞器进行单肺通气患者的临床疗效及安全性。方法将46例进行胸部外科手术患者随机分为对照组和试验组,每组23例。对照组予以静脉麻醉诱导后静吸复合维持麻醉;试验组在对照组治疗的基础上,予以0.6μg·kg^(-1)右美托咪定,静脉注射,15 min后静脉诱导,同时以0.4μg·kg^(-1)·h^(-1)维持,并在术前30 min停止。比较2组患者入室后即刻(T1)、静脉诱导前即刻(T2)、气管插管前(T3)、插管即刻(T4)、插管后3 min(T5)和插管后5 min(T6)的血流动力学和炎症因子变化,T1、T3、T6时刻的血气分析结果,以及药物不良反应的发生情况。结果 T2时刻,试验组和对照组的平均动脉压(MAP)分别为(82.44±8.87)和(96.17±10.29)mm Hg,心率(HR)分别为(68.64±7.89)和(76.82±8.08)beat·min^(-1),差异均有统计学意义(均P<0.05)。T6时刻,试验组和对照组的MAP分别为(102.39±12.58)和(124.32±16.03)mm Hg,HR分别为(84.84±8.68)和(89.54±9.39)beat·min^(-1),肿瘤坏死因子-α分别为(24.33±3.32)和(30.44±4.08)pg·m L^(-1),白细胞介素-6分别为(22.83±3.14)和(28.77±3.89)pg·m L^(-1),白细胞介素^(-1)0分别为(29.18±4.08)和(35.22±5.01)pg·m L^(-1),动脉血氧分压分别为(57.82±8.09)和(52.28±7.12)k Pa,氧合指数分别为(242.27±32.34)和(174.62±22.88)mm Hg,差异均有统计学意义(均P<0.05)。2组患者治疗期间均未发生药物不良反应。结论右美托咪定注射液能改善置入支气管阻塞器进行单肺通气者的血流动力学和炎症状态,且安全性较高。Objective To observe the clinical efficacy and safety of dexmedetomidine injection in the treatment of patients with single lung ventilation with bronchial obstruction. Methods A total of 46 patients undergoing thoracic surgery were randomly divided into control and treatment groups with 23 cases per group. Control group was treated with intravenous anesthesia and static inhalation compound maintenance anesthesia. on the basis of control group. Treatment group was treated with 0. 6 μg·kg^（-1） dexmedetomidine,intravenous injection,venous induction after 15 min,maintained with 0. 4 μg·kg^（-1）·h^（-1）,and stopped at 30 min before operation. Changes of hemodynamics and inflammatory factors were compared at immediately after the burglary detection（ T1）,immediately before intravenous induction（ T2）,before intubation（ T3）,immediately after intubation（ T4）,3 min after intubation（ T5）,5 min after intubation（ T6）,the results of blood gas analysis at T1,T3 and T6,and adverse drug reactions were compared between two groups. Results At T2,the mean arterial pressure（ MAP） in treatment and control groups were（ 82. 44 ± 8. 87） and（ 96. 17 ± 10. 29） mm Hg,heart rate（ HR） were（ 68. 64 ± 7. 89） and（ 76. 82 ± 8. 08） beat·min^（-1）,the differences were all statistically significant（ all P 〈0. 05）. At T6,the MAP in treatment and control groups were（ 102. 39 ± 12. 58） and（ 124. 32 ± 16. 03） mm Hg,HR were（ 84. 84 ± 8. 68） and（ 89. 54 ± 9. 39） beat · min^（-1）,tumor necrosis factor-α were（ 24. 33 ± 3. 32） and（ 30. 44 ±4. 08） pg·m L^（-1）,interleukin-6 were（ 22. 83 ± 3. 14） and（ 28. 77 ± 3. 89） pg·m L^（-1）,interleukin^（-1）0 were（ 29. 18 ± 4. 08） and（ 35. 22 ± 5. 01） pg · m L^（-1）,arterial oxygen partial pressure were（ 57. 82 ± 8. 09） and（ 52. 28 ± 7. 12） k Pa,oxgenation index were（ 242. 27 ± 32. 34） and（ 174. 62 ± 22. 88） mm Hg,the differences were all statistically sign

关 键 词：右美托咪定注射液 支气管阻塞器 单肺通气 安全性 

分 类 号：R971.2[医药卫生—药品]