右美托咪定复合全身麻醉对肝癌切除术患者麻醉效果和血流动力学的影响研究  

Research on the impacts of dexmedetomidine combined with general anesthesia on anesthesia effect and hemodynamics in patients undergoing liver cancer resection

作　　者：何慧娟 漆勇[1] 李萍 毕兴华 刘礼霞[1] HE Huijuan;QI Yong;LI Ping;BI Xinghua;LIU Lixia(Department of Anesthesiology,Ningbo Medical Center Lihuili Hospital,Ningbo315000,China)

机构地区：[1]宁波市医疗中心李惠利医院麻醉科,浙江宁波315000

出　　处：《中国现代医生》2021年第9期129-133,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019ZD047)。

摘　　要：目的分析予以肝癌切除术患者右美托咪定复合全麻的麻醉效果及对血流动力学的影响。方法将2018年1月至2020年6月于本院择期开展全麻肝癌切除术的200例患者为研究对象,依据随机数表法分成对照组(全麻诱导前10 min静脉予0.9%氯化钠注射液)和观察组(全麻诱导前10 min静脉予右美托咪定)各100例,比较两组不同时间点平均动脉压(MAP)与心率、静息疼痛数字评分(NRS)与Ramsay镇静评分、术中血管活性药使用比例、麻醉药用量、术后并发症与首次排气时间。结果观察组T1、T2、T4、T5、T6及T7的MAP水平和T1、T3、T4、T5及T6的心率水平低于对照组,T4、T5、T6及T7的静息NRS和T4、T5的Ramsay镇静评分低于对照组,差异有统计学意义(P<0.05);观察组瑞芬太尼、丙泊酚及曲马多用量少于对照组,艾司洛尔以及乌拉地尔使用比例低于对照组,阿托品使用比例高于对照组,差异有统计学意义(P<0.05);观察组并发症出现少于对照组,术后排气时间短于对照组,差异有统计学意义(P<0.05)。结论对行肝癌切除术的患者开展右美托咪定复合全麻能获取良好围术期镇痛镇静效果,且血流动力学及麻醉恢复期平稳,能减少麻醉及镇痛药用量,减少并发症出现,有助于术后肠道功能恢复。Objective To analyze the impacts of dexmedetomidine combined with general anesthesia on anesthesia effect and hemodynamics in patients undergoing liver cancer resection.Methods A total of 200 patients undergoing liver cancer resection under general anesthesia admitted to our hospital from January 2018 to June 2020 were selected as the research objects,and they were divided into the control group(n=100)and the observation group(n=100)according to the random number table method.The control group was intravenously given 0.9%sodium chloride injection 10 min before induction of general anesthesia,while the observation group was intravenously given dexmedetomidine 10 min before induction of general anesthesia.The mean arterial pressure(MAP),heart rate,resting pain numerical rating scale(NRS),Ramsay sedation score,proportion of vasoactive drugs used during operation,anesthetic dosage,incidence of postoperative complications and first exhaust time were compared between the two groups at different time points.Results MAP levels of T1,T2,T4,T5,T6 and T7 and heart rate levels of T1,T3,T4,T5 and T6 in the observation group were lower than those in the control group,while resting NRS of T4,T5,T6 and T7 and Ramsay sedation scores of T4 and T5 were lower than those in the control group,with statistically significant differences(P<0.05).In the observation group,the dosage of remifentanil,propofol and tramadol was less than that in the control group,the proportion of esmolol and urapidil in the observation group was lower than that in the control group,and the proportion of atropine in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).The incidence of complications in the observation group was less than that in the control group,and the postoperative exhaust time was shorter than that in the control group,with statistically significant differences(P<0.05).Conclusion The application of dexmedetomidine combined general anesthesia in patients undergoing liver cancer re

关 键 词：肝癌切除术 全身麻醉 右美托咪定 麻醉效果 血流动力学 平均动脉压 

分 类 号：R614[医药卫生—麻醉学]