小剂量右美托咪定对合并高血压的老年和非老年甲状腺手术患者的影响比较  

Effects of low dose of dexmedetomidine on hemodynamics and adverse effects in elderly and non-elderly patients with hypertension complicated with thyroid surgery

作　　者：田振 刘伟 汪小海[2] 戴体俊 TIAN Zhen;LIU Wei;WANG Xiao-Hai(Department of Anesthesiology,Suqian People＇s Hospital,Suqian 223800,Jiangsu,China)

机构地区：[1]南京鼓楼医院集团宿迁市人民医院徐州医科大学附属宿迁医院麻醉科,江苏宿迁223800 [2]南京鼓楼医院麻醉科 [3]徐州医科大学麻醉药理学教研室

出　　处：《中国老年学杂志》2018年第19期4669-4671,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金项目(30872432)

摘　　要：目的评价右美托咪定对合并高血压的老年和非老年甲状腺手术患者血流动力学和麻醉恢复期不良反应的影响。方法行甲状腺手术且合并高血压的非老年患者30例为A组,同期行甲状腺手术且合并高血压的老年患者30例为B组,两组均在常规麻醉方法基础之上使用小剂量右美托咪定,记录两组血流动力学的波动状况和患者在麻醉恢复期不良反应等情况。结果两组丙泊酚使用量及瑞芬太尼使用量差异存在统计学意义(P<0. 05);与T1时间点相比,A组患者在T2、T3、T4时的心率及平均动脉压(MAP)差异存在统计学意义(P<0. 05),而两组在T2、T3及T4时的心率和MAP差异均存在统计学意义(P<0. 05);两组镇静-躁动评分(SAS)比较差异有统计学意义(P<0. 05),两组苏醒期躁动人数和呛咳人数比较差异有统计学意义(P<0. 05)。结论和年轻患者相比,静脉泵注小剂量右美托咪定可以显著降低合并高血压的老年甲状腺手术患者血流动力学的波动状况,麻醉药物使用量较少且不影响苏醒时间,不良反应少。Objective To survey the effects of low dose of dexmedetomidine on hemodynamics and adverse effects in elderly and non-elderly patients with hypertension complicated with thyroid surgery. Methods 30 non-elderly hypertension patients with thyroid surgery were selected as A group. While 30 elderly hypertension patients with thyroid surgery were selected as B group. The two groups were both given routine anesthesia and low dose of dexmedetomidine. The fluctuation of hemodynamics and adverse reactions during the recovery period were recorded in the two groups. Results There were significant differences between the two groups in the usages of propofol and remifentanil （P〈0.05）. Compared with those of T1 time point,! the heart rate and MAP of A group at T2, 13, T4 were statistically significant （P〈 0.05 ）. There were significant differences in heart r-te and MAP between group A and group B at the time of T2, 13 and T4 （P〈0.05）. There were significant differences in SAS score between the two groups （P〈0.05）. There were significant differences in the number of restlessness in recovery period and the number of coughing between the two groups （P〈0.05 ）. Conclusions Compared with young patients,low dose of dexmedetomidine could reduce the hemodynamic fluctuations and the usage of narcotic drugs in elderly hypertension patients undergoing thyroid surgery significantly. It does not affect the recovery time and has less adverse reactions.

关 键 词：高血压 甲状腺手术 右美托咪定 

分 类 号：R544.1[医药卫生—心血管疾病]