不同负荷剂量的右美托咪定复合丙泊酚对良性前列腺增生患者的影响  

Effects of different loading doses of dexmedetomidine combined with propofol on the patients with benign prostatic hyperplasia

作　　者：陈君 刘小妮 Chen Jun;Liu Xiaoni(Department of Pharmacy,Ankang Central Hospital,Shaanxi Province,Ankang 725099,China)

机构地区：[1]安康市中心医院药剂科,陕西安康725099

出　　处：《海军医学杂志》2022年第7期737-743,共7页Journal of Navy Medicine

摘　　要：目的探讨不同负荷剂量的右美托咪定复合丙泊酚对良性前列腺增生患者导管相关膀胱刺激征及生殖激素水平的影响。方法前瞻性纳入2018年8月至2020年8月于安康市中心医院行经尿道前列腺电切术(trans urethral resection prostate,TURP)的92例良性前列腺增生患者作为研究对象,通过随机数字表法将其分为3组,其中对照组31例(常规麻醉),观察A组31例(使用右美托咪定0.5μg/kg+丙泊酚2 mg/kg麻醉),观察B组30例(使用右美托咪定1.0μg/kg+丙泊酚2 mg/kg麻醉)。比较3组患者围手术期的相关指标、不同时间点平均动脉压(mean arterial pressure,MAP)、心率、生殖激素水平、血清肾上腺素(epinephrine,E)、去甲肾上腺素(nore pinephrine,NE)及术后6、24 h血清C反应蛋白(C-reactive protein,CRP)水平,记录3组患者术后8、24 h视觉模拟评分(visual analogue scale/score,VAS)和Ranmsay镇静评分,并统计术后导管相关膀胱刺激征发生率。结果观察组患者术中丙泊酚用量及手术时间显著少于对照组,且观察B组患者少于观察A组(F=10.493,0.699);观察组患者清醒时间明显长于对照组,且观察B组患者较观察A组更长(F=107.718,P<0.05);在泵入右美托咪定后10 min(T2)、手术开始后2 h(T3)观察组患者MAP值和心率均显著低于对照组,且观察B组患者较观察A组更低(F=16.454,10.407,13.259,10.431,P<0.05);组内MAP值对比,不同时间点的MAP值差异有统计学意义(F=11.016,27.535,12.100,18.429,P<0.05);观察组患者的血清E、NE水平均明显低于对照组,且观察B组患者较观察A组更低(F=84.417,94.712,P<0.05);3组患者术后6、24 h的CRP水平差异具有统计学意义,其中观察B组<观察A组<对照组(F=75.931,6.394,P<0.05);组内对比,3组患者术后24 h CRP水平均较术后6 h显著偏高(t=8.047,7.535,5.504,P<0.05);术后24 h,观察组患者血清睾酮(tewsterone,T)、雌激素(estrogenic hormone,E2)水平均显著高于对照组,且观察B组患者高于观察A组(F=191.Objective To explore the effects of different loading doses of dexmedetomidine combined with propofol on cathe-ter-related bladder irritation and reproductive hormones in the patients with benign prostatic hyperplasia(BPH).Methods 92 pa-tients with benign prostatic hyperplasia who received transurethral resection of prostate(TURP)in the hospital from August 2018 to August 2020 were prospectively recruited as research subjects,and were randomly divided into the control group(n=31)with routine anesthesia,the observation group A(n=31)with dexmedetomidine 0.5μg/kg+2 mg/kg anesthesia and the observation group B(n=30)with dexmedetomidine 1.0μg/kg+2 mg/kg anesthesia.The related indexes,the levels of mean arterial pressure(MAP)at differ-ent time points,heart rate,reproductive hormone,serum epinephrine(E),norepinephrine(NE)and serum C-reactive protein(CRP)at hour 6 and hour 24 after surgery were compared between the three groups.The visual analogue scale/scores(VAS)and Ranmsay sedation scores at hour 8 and hour 24 after surgery in the three groups were recorded,and the incidence of postoperative cath-eter-related bladder irritation was statistically analyzed.Results The dosage of propofol and the duration of surgical time in the obser-vation group were significantly less than those in the control group(F=10.493,0.699).The awakening time of the observation group was significantly longer than that of the control group,and the awakening time of the observation group B being longer than that of the observation group A(F=107.718,P<0.05).Ten minutes after pumping of dexmedetomidine(T2),2 hours after surgery(T3),the MAP value and heart rate of the observation group were all lower than those of the control group,with that of the observation group B being even lower than that of the observation group A(F=16.454,10.407,13.259,10.431,P<0.05).When comparisons of MAP were made between the groups,there was statistical significance in MAP values at different time points(F=11.016,27.535,12.100,18.429,P<0.05).The levels of serum E and N

关 键 词：不同负荷剂量 右美托咪定 丙泊酚 良性前列腺增生 导管相关膀胱刺激征 生殖激素水平 

分 类 号：R452[医药卫生—治疗学]