右美托咪定复合芬太尼对立体定向颅内血肿微创抽吸术治疗高血压脑出血患者的麻醉效果分析  

Anesthetic Effect of Dexmedetomidine Combined with Fentanyl on Patients with Hypertensive Cerebral Hemorrhage Treated by Stereotactic Minimally Invasive Aspiration of Intracranial Hematoma

作　　者：于红美[1] 王琦[1] 李睿[1] 李少泉[2] YU Hong-mei;WANG Qi;LI Rui;LI Shao-quan(Department of Anesthesiology,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Neurosurgery,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院麻醉科,河北沧州061000 [2]沧州市中心医院神经外科,河北沧州061000

出　　处：《解放军医药杂志》2019年第12期94-97,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅科研基金项目(20191252)

摘　　要：目的分析右美托咪定复合芬太尼对立体定向颅内血肿微创抽吸术治疗高血压脑出血患者的麻醉效果。方法将2017年4月—2018年8月治疗的74例高血压脑出血患者作为研究对象,根据麻醉方案的不同分为对照组和观察组,每组37例。对照组采用丙泊酚复合芬太尼麻醉,观察组采用右美托咪定复合芬太尼麻醉。比较2组的血压、心率(HR)、血氧分压(PaO2)、二氧化碳分压(PaCO2)、镇静效果以及不良反应发生率。结果麻醉前,2组收缩压(SBP)、舒张压(DBP)、HR、PaO2、PaCO2比较差异均无统计学意义(P>0.05)。钻孔时,观察组SBP、DBP、PaO2明显高于对照组,HR、PaCO2均明显低于对照组(P<0.05)。观察组的镇静良好率明显高于对照组,躁动不安和心动过速发生率均显著低于对照组(P<0.05)。结论立体定向颅内血肿微创抽吸术中应用右美托咪定复合芬太尼对高血压脑出血患者麻醉效果较好,能有效提高镇静效果,且不良反应发生率低,有较高的安全性。Objective To analyze anesthetic effect of Dexmedetomidine combined with Fentanyl on patients with hypertensive cerebral hemorrhage treated by stereotactic minimally invasive aspiration of intracranial hematoma.Methods A total of 74 patients with hypertensive cerebral hemorrhage treated during April 2017 and August 2018 were divided into control group and observation group(n=37 in each group)according to different anesthesia methods.Control group was anesthetized by Propofol combined with Fentanyl,while observation group was anesthetized with Dexmedetomidine combined with Fentanyl.Levels of blood pressure,heart rate(HR),partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),sedative effects and incidence rate of adverse reactions were compared between two groups.Results There were no significant differences in levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),HR,PaO2 and PaCO2 before anesthesia between two groups(P>0.05).At the time of boring,in observation group,SBP,DBP and PaO2 levels were significantly higher,while HR and PaCO2 levels were significantly lower than those in control group(P<0.05).In observation group,good rate of sedation was significantly higher,while incidence rate of restlessness and tachycardia was significantly lower than those in control group(P<0.05).Conclusion Dexmedetomidine combined with Fentanyl in application of patients with hypertensive cerebral hemorrhage treated by stereotactic minimally invasive aspiration of intracranial hematoma may achieve good anesthetic effect and effectively improve sedative effect with lower incidence rate of adverse reactions and better safety.

关 键 词：右美托咪定 芬太尼 丙泊酚 颅内出血 高血压性 立体定向颅内血肿微创抽吸术 麻醉 镇静 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R614[医药卫生—临床医学]