右美托咪定浓度对输卵管性不孕宫腹腔镜术全身麻醉苏醒拔管期间应激反应及血流动力学影响  

Effect of different concentrations of dexmedetomidine on stress response and hemodynamics of women with tubal infertility during general anesthesia recovery when extubation after hysteroscopy and laparoscopy operation

作　　者：李俊[1] 许秋平[1] 彭学 刘艳[1] 丁汉琳[2] LI Jun;XU Qiuping;PENG Xue;LIU Yan;DING Hanlin(Puren Hospital Affiliate to Wuhan University of Science and Technology, Hubei Province, 430000;Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Sciences)

机构地区：[1]武汉科技大学附属普仁医院,430000 [2]湖北省襄阳市中心医院,湖北文理学院附属医院

出　　处：《中国计划生育学杂志》2020年第12期2008-2012,2137,共6页Chinese Journal of Family Planning

摘　　要：目的:分析不同浓度右美托咪定对输卵管性不孕患者宫腹腔镜术全身麻醉苏醒拔管期间应激反应及血流动力学影响。方法:选取2018年1月—2019年1月在本院妇产科行宫腹腔镜联合手术的输卵管性不孕患者112例,分为对照组、右美托咪定低剂量组(0.25μg/kg)、中剂量组(0.50μg/kg)、高剂量组(1.00μg/kg)各28例,比较各组手术、拔管、苏醒时间;比较给药前(T1)、拔管前1min(T2)、拔管时(T3)、拔管后3min(T4)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)变化,比较T1、T2、T4时间点患者血浆皮质醇(COR)、肾上腺素(ADR)水平。观察术后不良反应。结果:高剂量组拔管时间(27.06±7.35min)、苏醒时间(19.58±2.74min)高于对照组和低、中剂量组(P<0.05);COR、ADR水平,在T2、T4时对照组较T1时升高,T2、T4时右美托咪定各剂量组均低于对照组,在T4时中、高剂量组低于低剂量组(均P<0.05);SBP、DBP在T2时右美托咪定各剂量组均低于对照组,T3、T4时中、高剂量组均低于对照组(均P<0.05);MAP、HR水平,T3、T4时对照组和低剂量组高于T1、T2时,T3、T4时中、高剂量组低于对照组(均P<0.05)。对照组和低剂量组心动过速及高血压的发生率高于中、高剂量组,高剂量组心动过缓及低血压发生率高于对照组及低、中剂量组(均P<0.05)。结论:0.50μg/kg剂量的右美托咪定用于输卵管性不孕患者宫腹腔镜术全身麻醉苏醒后,可有效降低患者术后应激反应,促进血流动力学稳定,且不良反应较小。Objective:To analyze the effect of different concentrations of dexmedetomidine on stress response and hemodynamics of women with tubal infertility during general anesthesia recovery when extubation after hysteroscopy and laparoscopy operation.Methods:112 women with tubal infertility who underwent operation by hysteroscopy combined with laparoscopy from January 2018 to January 2019 were randomly divided into 28 women in control group,28 women(given 0.25μg/kg dexmedetomidine)in group A,28 women(given 0.50μg/kg dexmedetomidine)in group B,and 28 women(given 1.00μg/kg dexmedetomidine)in group C.The operation time,extubation time,and recovery time of women were compared among the four groups.The values of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),and heart rate(HR)of women before administration(T1),1 minute before extubation(T2),3 minutes after extubation(T4)were also compared among the four groups.And the levels of plasma cortisol(COR)and adrenal gland of women at T1,T2 and T4 were compared among the four groups.The incidence of adverse reactions of women in each group was observed.Results:The extubation time(27.06±7.35 min)and recovery time(19.58±2.74 min)of women in group C were significant higher than those of women in the control group,group A and B(P<0.05).In the control group,the COR and ADR levels of women at T2 and T4 were significant higher than those at T1.The COR and ADR levels of women at T2 and T4 of women in group A,B,and C were significant lower than those of women in the control group.The COR and ADR levels of women at T4 of women in group C were significant lower than those of women in group A(all P<0.05).The SBP and DBP values of women at T2 of women in group A,B,and C were significant lower than those of women in the control group.The SBP and DBP values of women at T3 and T4 of women in group B and C were significant lower than those of women in the control group(all P<0.05).The MAP and HR levels of women in the control group and group A at T3 and T4

关 键 词：输卵管性不孕 宫腹腔镜术 麻醉苏醒 右美托咪定 不同剂量 应激反应 血流动力学 

分 类 号：R71[医药卫生—妇产科学]