右美托咪啶在高血压脑出血锥颅术全麻中的临床分析  

Clinical Analysis of Dexmedetomidine in the General Anesthesia of Hypertensive Cerebral Hemorrhage Craniotomy

作　　者：邱立国[1] QIU Li-guo(Department of Anesthesia,Donghai People’s Hospital,Lianyungang,Jiangsu Province,222300 China)

机构地区：[1]江苏省东海县人民医院麻醉科,江苏连云港222300

出　　处：《中外医疗》2018年第8期112-113,116,共3页China & Foreign Medical Treatment

摘　　要：目的探讨右美托咪啶在高血压脑出血锥颅术全麻中的实际效果。方法方便选取该院2015年1月—2017年12月收治的高血压脑出血患者60例作为该次研究对象,随机分为对照组和观察组各30例,两组均使用锥颅术治疗,观察组采用右美托咪啶进行全身麻醉,对照组采用异丙酚进行全身麻醉,观察两组不同时间点(T_0:静脉给药即刻、T_1:静脉给药5 min、T_2:静脉给药15 min、T_3:静脉给药30 min、T_4:手术结束时)血流动力学及生命体征变化情况,并对比两组术中不良反应发生情况。结果观察组T_2、T_3、T_4时间点MAP(平均动脉压)、HR(心率)均低于T_0(P<0.05)。对照组T_0、T_2、T_3、T_4等时间点MAP分别为(124.98±3.25)mm Hg、(96.69±3.15)mm Hg、(98.81±3.33)mm Hg、(99.89±3.29)mm Hg,对照组T_0、T_2、T_3、T_4等时间点HR分别为(79.92±3.68)次/min、(75.89±3.41)次/min、(74.92±3.52)次/min、(78.29±3.24)次/min,对照组T_2、T_3、T_4时间点MAP均低于T_0(P<0.05)。观察组T_2、T_3、T_4时间点HR均低于对照组(P<0.05)。观察组术中不良反应发生率为3.33%,明显低于对照组的20.00%(P<0.05)。结论右美托咪啶在高血压脑出血锥颅术全麻中应用,患者生命体征稳定,且安全性高,建议在临床上推广。Objective To study the practical effect of dexmedetomidine in the general anesthesia of hypertensive cerebral hemorrhage craniotomy.Methods 60 cases of patients with hypertensive cerebral hemorrhage admitted and treated in our hospital from January 2015 to December 2017 were selected and randomly divided into two groups with 30 cases in each,both groups were treated with craniotomy,and the observation group were treated with dexmedetomidine for general anesthesia,while the control group were treated with propofol for general anesthesia,and the hemodynamics(T0:intravenous administration immediately,T1:intravenous administration 5 min,T2:intravenous administration 15 min,T3:intravenous administration 30 min and T4:at the end of operation)and changes of vital signs,and occurrence of adverse reactions in operation were compared between the two groups.Results The MAP and HR at T2,T3,T4 in the observation group were lower than that at T0(P<0.05),and the MAP at T0,T2,T3,T4 in the control group were respectively(124.98±3.25),(96.69±3.15),(98.81±3.33),(99.89±3.29)mmHg,and the HR at T0,T2,T3,T4 in the control group were respectively(79.92±3.68),(75.89±3.41),(74.92±3.52),(78.29±3.24)times/min,and the MAP in the control group at T2,T3,T4 in the control group was lower than that at T0(P<0.05),and the HR at T2,T3,T4 in the observation group was lower than that in the control group(P<0.05),and the incidence rate of adverse reactions in the observation group was obviously lower than that in the control group(3.33%vs 20.00%)(P<0.05).Conclusion The application of dexmedetomidine in the general anesthesia of hypertensive cerebral hemorrhage craniotomy can promote the steady vital signs,with high safety,which is suggested to be widely promoted.

关 键 词：右美托咪啶 高血压脑出血 锥颅术 

分 类 号：R5[医药卫生—内科学]