盐酸右美托咪定对颅内动脉瘤介入手术患者血流动力学的影响  

Effect of dexmedetomidine hydrochloride on hemodynamics of intracranial aneurysms patients undergoing interventional surgery

作　　者：史记 赵帅[2] 张娜娜 刘雅[4] 周长浩[1] SHI Ji;ZHAO Shuai;ZHANG Na-na;LIU Ya;ZHOU Chang-hao(Department of Anesthesiology,The First Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Department of Clinical Laboratory,The First Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Department of Pharmacy,The First Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Department of Anesthesiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]河北医科大学第一医院,麻醉科,河北石家庄050000 [2]河北医科大学第一医院,检验科,河北石家庄050000 [3]河北医科大学第一医院,药学部,河北石家庄050000,河北石家庄050000 [4]河北医科大学第二医院麻醉科,河北石家庄050000

出　　处：《中国临床药理学杂志》2021年第10期1142-1145,共4页The Chinese Journal of Clinical Pharmacology

基　　金：河北省医学科学研究重点课题计划基金资助项目(20160693)。

摘　　要：目的观察盐酸右美托咪定对颅内动脉瘤介入手术患者血流动力学的影响。方法将实施颅内动脉瘤介入术治疗的患者60例,随机分为对照组和试验组,各30例。对照组给予瑞芬太尼实施麻醉维持,试验组给予瑞芬太尼联合盐酸右美托咪定实施麻醉维持。比较2组患者不同时点血流动力学相关指标、临床时间指标、镇静效果和药物不良反应发生情况。结果试验组麻醉维持给药后15 min(T1)、麻醉维持给药后30 min(T2)、手术结束(T3)心率(HR)分别为(77.47±9.41),(79.47±6.11),(77.77±8.67)次/分,对照组分别为(68.23±5.51),(67.17±6.36),(71.23±6.41)次/分,试验组T1、T2、T3平均动脉血压(MAP)分别为(52.30±3.98),(85.03±7.46),(86.07±3.89)mmHg,对照组分别为(64.57±3.43),(63.67±5.07),(66.60±5.37)mmHg,差异均有统计学意义(均P<0.05)。试验组和对照组的拔管时间分别为(18.37±4.85),(13.93±4.73)min,拔管即刻躁动评分分别为(1.90±0.71),(2.37±0.62)分,拔管后5 min Ramsay镇静评分分别为(2.87±0.57),(2.43±0.57)分,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为3.33%,26.67%,差异有统计学意义(P<0.05)。结论盐酸右美托咪定在颅内动脉瘤介入手术中的应用,可保证患者血流动力学稳定,且镇静效果理想。Objective To explore the effect of dexmedetomidine hydrochloride on hemodynamics in patients underwent intracranial aneurysm interventional surgery. Methods A total of 60 patients with intracranial aneurysm interventional therapy were randomly divided into control group and treatment group, with 30 cases in each group. Control group was given remifentanil for anesthesia maintenance, treatment group was given remifentanil combined with dexmedetomidine hydrochloride for anesthesia maintenance. The hemodynamic-related indexes, clinical time indexes, sedative effect and the incidence of adverse drug reactions in two gorups were compared at different time points. Results At 15 min maintenance administration of anesthesia(T1), 30 min(T2) and the end of the operation(T3), the heart rate(HR) in treatment group were(77.47±9.41),(79.47±6.11),(77.77±8.67) times·min-1, which in control group were(68.23±5.51),(67.17±6.36),(71.23±6.41) times·min-1;the mean arterial blood pressure(MAP) at T1,T2,T3 in treatment group were( 52. 30 ± 3. 98),( 85. 03 ± 7. 46),( 86. 07 ± 3. 89) mmH g,which in control group were( 64. 57 ± 3. 43),( 63. 67 ± 5. 07),( 66. 60 ± 5. 37) mmH g,all with significant difference( all P < 0. 05).The extubation time of treatment group and control group were( 18. 37 ± 4. 85),( 13. 93 ± 4. 73) min,the immediate restlessness scores were( 1. 90 ± 0. 71),( 2. 37 ± 0. 62) points,5 min after extubation Ramsay sedation scores were( 2. 87 ± 0. 57),( 2. 43 ± 0. 57) points,all with significant difference( all P < 0. 05). The total incidence of adverse drug reactions in treatment group and control group were 3. 33%,26. 67%,with significant difference( P < 0. 05).Conclusion The application of dexmedetomidine hydrochloride in the interventional operation of intracranial aneurysm can ensure the stability of hemodynamics and the sedative effect is ideal.

关 键 词：血流动力学 颅内动脉瘤 盐酸右美托咪定 镇静 

分 类 号：R971[医药卫生—药品]