右美托咪定在高血压患者脑动脉瘤栓塞术中的应用  

Application of dexmedetomidine in cerebral aneurysm embolization in patients with hypertension

作　　者：张耀贤[1] 刘喜成[1] 张秋丽[1] 刘占立[1] 吴文燕[1] ZHANG Yaoxian;LIU Xicheng;ZHANG Qiuli;LIU Zhanli;LIU Zhanli(Department of Anesthesiology,the Second Clinical Medical College,Jinan University,Shenzhen People′s Hospital,Shenzhen,518020,China)

机构地区：[1]暨南大学第二临床医学院,深圳市人民医院麻醉科,广东省深圳市518020

出　　处：《实用医学杂志》2017年第14期2365-2367,共3页The Journal of Practical Medicine

摘　　要：目的研究右美托咪定应用于高血压患者脑动脉瘤栓塞术中的麻醉效果。方法选择60例急诊行脑动脉瘤栓塞术患者,均合并高血压,随机分为研究组(右美托咪定组)和对照组,每组30例。观察并记录患者入室时(T_0)、气管插管前(T_1)、气管插管后即刻(T_2)、气管导管拔除后即刻(T_3)的收缩压(SBP)、舒张压(DBP)、心率(HR)和血浆去甲肾上腺素(NE)浓度;记录两组患者拔管时间和不良反应发生率。结果研究组患者的血流动力学指标和NE在围术期不同时间点较对照组更加平稳,差异均有统计学意义(P<0.05);拔管时间两组无明显差异(P>0.05);研究组拔管后呛咳、烦躁的发生率低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定应用在合并有高血压的脑动脉瘤栓塞术患者中麻醉效果良好,可减少气管插管和拔除气管导管时的应激反应,使患者血流动力学更平稳,降低术后患者不良反应发生率。Objective To observe the effect of dexmedetomidine in cerebral aneurysm embolization in patients with hypertension.Methods Sixty patients with hypertension undergoing emergency cerebral aneurysm embolization were randomly divided into two groups:research group(dexmedetomidine given group)and control group.SBP,DBP,HR,plasma norepinephrine(NE):baseline value(T0),before intubation(T1),after intubation(T2),after extubation(T3).Extubation time and anesthetic-related complications were also recorded.Results The hemodynamic parameters and plasma norepinephrine concentration in the research group were more stable than those in the control group at different time point during perioperative period.There was no difference between two groups about extubation time.The incidence of anesthetic-related complications in research group was lower than control group(P<0.05).Conclusions Dexmedetomidine can reduce the stress response of intubation,extubation and perioperative hemodynamic fluctuations in cerebral aneurysm embolization in patients with hypertension.It can also reduce the consumption of prorofol and the incidences of adverse effects.

关 键 词：高血压 右美托咪定 脑动脉瘤栓塞术 

分 类 号：R614[医药卫生—麻醉学]