悬雍垂腭咽成形术患者右美托咪定不同给药方式的临床分析研究  

Clinical Analysis of Different Administration Methods of Dexmedetomidine in Patients Undergoing Uvula Palatopharyngoplasty

作　　者：韩成冰[1] 安世昌[1] 纪凡层[2] 和晓坡[1] HAN Chengbing;AN Shichang;JI Fanceng;HE Xiaopo(Department of Oral and Maxillofacial Surgery,Weifang People's Hospital,Weifang,Shandong Province,261041 China;Department of Anesthesiology,Weifang People's Hospital,Weifang,Shandong Province,261041 China)

机构地区：[1]潍坊市人民医院口腔颌面外科,山东潍坊261041 [2]潍坊市人民医院麻醉科,山东潍坊261041

出　　处：《中外医疗》2021年第29期54-57,共4页China & Foreign Medical Treatment

摘　　要：目的评价悬雍垂腭咽成形术(UPPP)患者右美托咪定不同给药方式的临床应用效果。方法随机选取该院于2019年3月—2020年3月期间行悬雍垂腭咽成形手术患者90例展开研究,随机分为3组(n=30):右美托咪定组持续泵入组(Y组);右美托咪定首次负荷剂量组(Y+S组);对照组即舒芬太尼组(S组)。记录不同时间两组的平均动脉压(MAP)、心率(HR),镇痛镇静效果与插管期间Ramsay值。结果S、Y+S、Y 3组患者在术后不同时间段,处于静息状态、吞咽状态下,VAS评分、Ramsay镇静评分改变情况相较差异无统计学意义(P>0.05);S组MAP、HR在经鼻气管插管后升高;Y组和Y+S组在T1时刻HR降低,分别为(54.8±6.6)次/min、(54.4±6.5)次/min变化显著,气管插管成功后MAP、HR水平波动较S组轻,与S组比较,Y组和Y+S组插管条件Ramsay评分升高,差异有统计学意义(P<0.05)。Y组术后48 h发生3例不良反应,Y+S组发生13例不良反应,S组发生5例不良反应。结论悬雍垂腭咽成形术患者右美托咪定用药治疗中,全麻诱导前给予右美托咪定1.0μg/kg,10 min泵入完毕,之后以0.1μg/(kg·h)持续泵入,手术结束前30 min停药,拔管平稳,苏醒质量高。Objective To evaluate the clinical application effect of dexmedetomidine with different administration methods in patients with uvulapalatopharyngoplasty(UPPP).Methods Ninety patients who underwent uvulopalatopharyngoplasty in this hospital from March 2019 to March 2020 were selected for the study,and they were randomLy divided into 3 groups(n=30):the dexmedetomidine group was continuously pumped into the group(Y group);dexmedetomidine first loading dose group(Y+S group);control group the sufentanil group(S group).The mean arterial pressure(MAP),heart rate(HR),analgesia and sedation effects and Ramsay values during intubation were recorded for the two groups at different times.Results There was no statistically significant difference in the changes of VAS scores and Ramsay sedation scores in the S,Y+S,and Y groups at different time periods after surgery,in the resting state and in the swallowing state(P>0.05);S group MAP HR and HR increased after nasal endotracheal intubation;group Y and Y+S group HR decreased at time T1,respectively(54.8±6.6)times/min,(54.4±6.5)times/min changed significantly.After successful tracheal intubation,the MAP and HR levels fluctuated less than those in group S,and compared with group S,Ramsay score of intubation condition in group Y and GROUP Y+S increased,the difference was statistically significant(P<0.05).3 adverse reactions occurred in the Y group 48 h after surgery,13 adverse reactions occurred in the Y+S group,and 5 adverse reactions occurred in the S group.Conclusion In the treatment of dexmedetomidine in patients undergoing uvulopalatopharyngoplasty,dexmedetomidine was given 1.0ug/kg before general anesthesia induction,and the pump was completed for 10 minutes,and then 0.1μg/(kg·h)was pumped continuously.The drug was stopped 30 minutes before the end of the operation,the extubation was smooth,and the recovery quality was high.

关 键 词：悬雍垂腭咽成形术 右美托咪定 给药方式 

分 类 号：R826.24[医药卫生—临床医学]