地佐辛联合右美托咪定在经尿道输尿管碎石术中的应用效果  

Application effect of Dizocine combined with Dexmedetomidine in transurethral ureteral lithotripsy

作　　者：陈进强 赵大忠 宋际明 张得戌 王双珠 CHEN Jin-qiang;ZHAO Da-zhong;SONG Ji-ming;ZHANG De-xu;WANG Shuang-zhu(Department of Anesthesiology,Longhua Central Hospital,Guangdong Province,Shenzhen 518100,China)

机构地区：[1]深圳市龙华区中心医院麻醉科,广东深圳518100

出　　处：《中国当代医药》2019年第11期137-139,143,共4页China Modern Medicine

基　　金：广东省市深圳龙华区科技计划医疗卫生项目(2017110)

摘　　要：目的探讨地佐辛联合右美托咪定在经尿道输尿管碎石术中的应用效果。方法选取2017年8月～2018年7月我院收治的行尿道输尿管碎石术的206例患者作为研究对象,随机分为对照组(51例)、A组(52例)、B组(51例)、C组(52例)。对照组采用地佐辛麻醉,A组采用地佐辛、0.17μg/(kg·h)右美托咪定麻醉,B组采用地佐辛、0.33μg/(kg·h)右美托咪定麻醉,C组采用地佐辛、0.70μg/(kg·h)右美托咪定麻醉,比较各时间段患者的血流动力学指标、镇静评分变化,统计各组用药期间的不良反应发生情况。结果 C组碎石时、灌洗时的平均动脉压(MAP)、心率(HR)均低于其他三组,镇静评分高于其他三组,差异有统计学意义(P<0.05);B组碎石时、灌洗时的MAP、HR低于对照组与A组,镇静评分高于对照组与A组(P<0.05);C组的不良反应总发生率高于其他三组,差异有统计学意义(P<0.05)。结论经尿道输尿管碎石术中以地佐辛、右美托咪定联合麻醉效果较好,且0.33μg/(kg·h)剂量的右美托咪定使用镇静效果好,不良反应少。Objective To investigate the effect of Dextrozine combined with Dexmedetomidine in transurethral ureteral lithotripsy.Methods A total of 206 patients who underwent urethral ureteral lithotripsy from August 2017 to July 2018 treated in our hospital were enrolled in the study.They were randomly divided into control group(n=51),group A(n=52),group B(n=51),and group C(n=52).In the control group,Dizocine for anesthesia was used.In the group A,Dizocine combined with 0.17 μg/(kg·h)Dexmedetomidine for anesthesia was used.In the group B,Dizocine combined with 0.33 μg/(kg·h)Dexmedetomidine for anesthesia was used.In the group C,Dextrozine combined with 0.70 μg/(kg·h)Dexmedetomidine for anesthesia was adopted.The hemodynamic indicators and sedation scores were compared among the four groups.The occurrence of adverse reactions during medication in each group was calculated.Results The mean arterial pressure(MAP)and heart rate(HR)of the group C was lower than those of the other three groups during the lithotripsy and lavage,and the sedation score was lower than those in the other three groups,with statistical significances(P<0.05).The MAP and HR of the group B was lower than those of the control group and group A,and the sedation score was higher than that in the control group and group A(P<0.05).The total incidence of adverse reactions in the group C was higher than those in the other three groups,with statistical significance(P<0.05).Conclusion The combined anesthesia with Dextrozine and Dexmedetomidine in transurethral ureteral lithotripsy obtains a great effect,and the sedative effect is better,and adverse reactions are fewer in the use of medium-dose of Dexmedetomidine.

关 键 词：碎石 右美托咪定 麻醉 应激反应 地佐辛 

分 类 号：R693.4[医药卫生—泌尿科学]