右美托咪定联合依托咪酯在输卵管性不孕宫腹腔镜手术麻醉中的量效学研究及应激因子水平变化  

Dose-eft study of dexmedetomidine combined with etomidate for anesthesia during hysteroscopice and laparoscopic surgery of patients with tubal inferility and the changes of stress factor levels

作　　者：陈林[1] 苏杰 佘永军 CHEN Lin;SU Jie;SHE Yongjun(Tangshan Second Hospital,Tangshan,Hebei Province,063015;Cang County Hospital,Hebei Province;Tang County People's Hospital(The Fourth Central Hospital of Baoding City),Baoding,Hebei Province)

机构地区：[1]河北省唐山市第二医院,063015 [2]河北省沧县医院 [3]河北省唐县人民医院(保定市第四中心医院)

出　　处：《中国计划生育学杂志》2023年第4期863-868,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨右美托咪定联合依托咪酯用于输卵管性不孕患者宫腹腔镜手术麻醉的量效学关系及应激因子水平变化。方法:选择2018年6月-2021年4月本院收治的输卵管性不孕行宫腹腔镜手术患者160例,随机数字表法分4组各40例,分别为用药A组(依托咪酯+低剂量右美托咪定)、用药B组(依托咪酯+中剂量右美托咪定)、用药C组(依托咪酯+高剂量右美托咪定)、对照组(单一依托咪酯)。比较各组干预前后临床指标、血流动力学指标、应激因子水平,记录不良反应。结果:拔管时长以及苏醒时长用药C组高于另外3组;DBP及SBP水平,T2时用药A组、用药B组、用药C组均低于对照组,T3、T4时用药B组、用药C组均低于对照组;MAP及HR水平,T1、T2时对照组、用药A组低于T3、T4时,T3、T4时用药B组及用药C组均低于对照组;COR、ADR水平,T3、T4时对照组高于T1时,用药A组、用药B组、用药C组均低于对照组,T4时用药B组、用药C组均低于用药A组(均P<0.05)。两组输术后均无严重不良反应出现。心率过快及血压过高发生率,对照组和用药A组均高于用药B组和用药C组,用药C组高于对照组和用药A组和用药B组,不良反应总发生率用药B组低于另外3组(均P<0.05)。结论:中剂量右美托咪定联合依托咪酯用于输卵管性不孕宫腹腔镜手术麻醉中不良反应少,安全性最高,能有效改善患者的临床指标以及血流动力学指标,减缓应激反应。Objective:To explore the dosereffect study of dexmedetomidine combined with etomidate for anesthesia dur-ing hysteroscopic and laparoscopic surgery of patients with tubal infertility,and to analyze the changes of the stress factor levels of the patients.Methods:160 patients with tubal infertility who wanted hysteroscopic and laparoscopic surgery were selected and were divided into four groups(40 cases in each group)according to the random number table method from June 2018 to April 2021.The patients in group A were given etomidate combined with low-dose dexme-detomidine for anesthesia during surgery,the patients in group B were given etomidate combined with medium-dose dexmedetomidine for anesthesia during surgery,the patients in group C were given etomidate combined with high-dose dexmedetomidine for anesthesia during surgery,and the patients in group D were given etomidate for anesthesia alone during surgery.The clinical indicators,the hemodynamic indicators,and the stress factors levels of the patients before and after intervention were compared among the four groups.The adverse reactions of the patients in the four groups were recorded.Results:The extubating time and recovery time of the patients in group C were significantly higher than those of the patients in the other three groups.The DBP and SBP levels of the patients in group A,group B,and group.C at T2 were significantly lower than those of the patients in group D,and those of the patients in groups B and C at T3 and T4 were significantly lower than those of the patients in group D.The MAP and HR levels of the patients in group D and group Aat T3 and T4 were significantly lower than those of the patients at T1 and T2.The MAP and HR levels of the patients in group A and group B and C at T3 and T4 were significantly lower than those of the patients in group D.The levels of COR and ADR of the patients in group D at T3 and T4 were significantly higher than those of the patients at T1,and those of the patients in group A,group B,and group C were significant

关 键 词：不孕症 宫腹腔镜手术 右美托咪定 不同剂量 依托咪酯 应激 

分 类 号：R614[医药卫生—麻醉学]