不同剂量右美托咪定联合七氟醚控制性降压在腹腔镜输尿管结石手术患者中的应用  

Application of different doses of Dexmedetomidine combined with Sevoflurane for controlled hypotension in patients with laparoscopic ureteral calculi surgery

作　　者：周浩[1] 高伟峰[1] 罗国万[1] 鲁银焕[1] 沈忠恩 何吉亮 Zhou Hao;Gao Weifeng;Luo Guowan(The Cixi people's hospital,Zhejiang 315300)

机构地区：[1]慈溪市人民医院,浙江慈溪315300

出　　处：《基层医学论坛》2021年第19期2668-2670,共3页The Medical Forum

基　　金：宁波市医学科技计划项目(2018A52);慈溪市社会发展科技计划项目(CN2018008)。

摘　　要：目的探讨不同剂量右美托咪定联合七氟醚控制性降压在腹腔镜输尿管结石手术患者中的应用效果。方法回顾性分析慈溪市人民医院2019年1月—2020年12月收治的60例腹腔镜输尿管结石手术患者临床资料,根据术中右美托咪定使用剂量不同,将0.2μg/kg右美托咪定+七氟醚控制性降压的20例患者设为0.2μg组,0.4μg/kg右美托咪定+七氟醚控制性降压的20例患者设为0.4μg组,0.6μg/kg右美托咪定+七氟醚控制性降压的20例患者设为0.6μg组。对比3组控制性降压前(T_(0))、降压后30 min(T_(1))、拔管后10 min(T_(2))及30 min(T_(3))时的血流动力学指标[心率(HR)、平均动脉压(MAP)],并对比3组苏醒质量。结果3组T_(1)、T_(2)、T_(3)时HR、MAP均较T_(0)时降低,但0.2μg组T_(1)、T_(2)、T_(3)时HR、MAP高于0.4μg组及0.6μg组,差异有统计学意义(P<0.05);0.2μg组患者睁眼及拔管时间最短,0.4μg组次之,0.6μg组最长,差异有统计学意义(P<0.05)。结论右美托咪定联合七氟醚控制性降压可提高腹腔镜输尿管结石手术患者麻醉苏醒质量,保持血流动力学稳定,0.2μg/kg右美托咪定更适合临床应用。Objective To investigate the effect of different doses of dexmedetomidine combined with sevoflurane in controlled hypotension in patients with laparoscopic ureteral calculi surgery.Methods The clinical data of 60 patients undergoing laparoscopic ureteral calculi surgery in our hospital from January 2019 to December 2020 were retrospectively analyzed.According to the different doses of intraoperative dexmedetomidine,0.2μg/kg dexmedeto The 20 patients with controlled hypotension by mididine+sevoflurane were set as the 0.2μg group,and the 20 patients with 0.4μg/kg dexmedetomidine+sevoflurane controlled hypotension were set as the 0.4μg group,0.620 patients withμg/kg dexmedetomidine+sevoflurane controlled hypotension were set as 0.6μg group.Compare the hemodynamics before(T_(0)),30min(T_(1)),10min(T_(2))and 30min(T_(3))after extubation in the three groups of controlled hypotension[heart rate(HR),mean arterial pressure(MAP)],And compare the recovery quality of the 3 groups.Results HR and MAP at T_(1),T_(2),and T_(3) in the three groups were lower than at T_(0),but the HR and MAP at T_(1),T_(2),and T_(3) in the 0.2μg group were higher than those in the 0.4μg group and 0.6μg group.The time-point interactive comparison showed that the difference was statistically significant(P<0.05);the 0.2μg group had the shortest eye opening and extubation time,followed by the 0.4μg group,and the 0.6μg group was the longest.The difference between the groups was statistically significant(P<0.05).Conclusion Dexmedetomidine combined with sevoflurane for controlled hypotension can improve the anesthesia quality of patients undergoing laparoscopic ureteral calculi surgery and maintain hemodynamic stability.0.2μg/kg dexmedetomidine is suitable for clinical application.

关 键 词：输尿管结石 腹腔镜 七氟醚 右美托咪定 控制性降压 

分 类 号：R4[医药卫生—临床医学]