小剂量右美托咪定对高龄患者髋关节置换术应激反应及术后恢复的影响  

Effect of low-dose dexmedetomidine on stress response and recovery after hip replacement in elderly patients

作　　者：车邦民[1] 李虎 薛剑锋 张干[1] 莫惠飞 CHE Bangmin;LI Hu;XUE Jianfeng;ZHANG Gan;MO Huifei(Baoan District People's Hospital,Shenzhen,Guangdong 518101,China)

机构地区：[1]深圳市宝安区人民医院,广东深圳518101

出　　处：《现代医院》2020年第5期741-743,共3页Modern Hospitals

基　　金：深圳市宝安区医疗卫生科研立项项目(2016CX167)。

摘　　要：目的探讨小剂量右美托咪定应用于高龄患者髋关节置换术对患者应激反应及术后恢复的影响。方法选取2016年2月-2017年6月收治的60例高龄髋关节置换术患者随机分为A组、B组、对照组3组各20例,A组给予常规剂量右美托咪定,B组泵入低剂量右美托咪定,对照组给予等量生理盐水,对3组麻醉结果进行比较。结果各组年龄、BMI、手术时间、出血量差异无统计学意义(P>0.05);各组t0、t4时HR、收缩压、舒张压差异无统计学意义(P>0.05),t1、t2、t3时A、B组的HR、收缩压、舒张压水平与对照组比较,相对更低(P<0.05);各组t0、t1时E、NE水平差异无统计学意义(P>0.05),A、B组t2时E、NE水平与对照组比较,相对更低(P<0.05),但A、B组两组间差异无统计学意义(P>0.05)。结论小剂量右美托咪定可有效维持患者血流动力学稳定性,围术期间可有效降低患者肾上腺素、去甲肾上腺素水平,减轻应激反应,促使患者安全度过围术期,值得应用及推广。Objective To study the effect of low-dose dexmedetomidine on stress response and postoperative recovery of elderly patients after hip replacement.Methods A total of 60 cases of elderly patients with hip replacement admitted in our hospital from February 2016 to June 2017 were randomly divided into three groups:group A,group B and control group,20 cases in each group.Group A was given regular dose of dexmedetomidine.Group B was treated with low-dose dexmedetomidine.The control group was given equivalent normal saline.The results of the three groups were compared after anesthesia.Results There was no significant difference in age,BMI,operation time and blood loss in each group(P>0.05).There was no significant difference in HR,systolic blood pressure and diastolic blood pressure in each group at t0and t4(P>0.05).The levels of HR,systolic blood pressure and diastolic blood pressure in group A and group B at t1,t2and t3were lower than those in the control group(P<0.05).There was no significant difference in E and NE levels in each group at t0and t1(P>0.05).The E and NE levels of the patients in Group A and group B were relatively lower than that in the control group at t2(P<0.05),but no significant difference were observed between group A and group B(P>0.05).Conclusion Low-dose dexmedetomidine can effectively maintain hemodynamic stability,reduce perioperative epinephrine and norepinephrine levels,reduce stress reaction,which is beneficial to help patients live through perioperative period.Therefore,it is worth spreading and applying.

关 键 词：小剂量 右美托咪定 高龄 髋关节置换术 应激反应 

分 类 号：R683.42[医药卫生—骨科学] R971+2[医药卫生—外科学]