右美托咪定联合超声引导下神经阻滞麻醉用于糖尿病足坏疽手术中的效果  

Effects of Dexmedetomidine Combined with Ultrasound-Guided Nerve Block Anesthesia on Diabetic Foot Gangrene Surgery

作　　者：郑名辉 史涛 ZHENG Minghui;SHI Tao(Hanzhong Central Hospital,Hanzhong Shaanxi 723000)

机构地区：[1]汉中市中心医院麻醉科,陕西汉中723000 [2]铜川市人民医院手术麻醉科,陕西铜川727031

出　　处：《医学临床研究》2023年第12期1832-1834,1838,共4页Journal of Clinical Research

基　　金：汉中市中心医院院级科研基金中标项目(编号:YK2101)。

摘　　要：【目的】探讨右美托咪定(Dex)与超声引导下神经阻滞麻醉联合用于糖尿病足坏疽手术中的效果。【方法】行糖尿病足坏疽手术的患者80例,随机分为两组,每组40例。对照组患者在超声引导下行神经阻滞麻醉,观察组在对照组基础上联合Dex进行麻醉。比较两组患者感觉、运动神经阻滞时间,麻醉前后不同时间点血流动力学[心率(HR)、血氧饱和度(SpO_(2))]变化,麻醉前及术后血清免疫功能指标[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平,记录不良反应发生率。【结果】观察组感觉及运动神经阻滞起效时间、完善时间均短于对照组(P<0.05);观察组感觉及运动神经阻滞持续时间均长于对照组(P<0.05)。观察组麻醉后HR显著高于对照组(P<0.05),观察组手术开始时HR低于同组麻醉后(P<0.05),对照组麻醉后HR显著低于同组麻醉前(P<0.05)。对照组术后CD4^(+)、CD4^(+)/CD8^(+)水平显著低于同组麻醉前(P<0.05),观察组术后CD4^(+)、CD4^(+)/CD8^(+)水平显著高于对照组术后(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】在超声引导下神经阻滞麻醉联合Dex用于糖尿病足坏疽手术中的麻醉效果显著,可有效延长神经阻滞时间,维持血流动力学稳定,且未增加不良反应发生率。【Objective】To explore the effects of dexmedetomidine(Dex)combined with ultrasound-guided nerve block anesthesia on diabetic foot gangrene surgery.【Methods】Eighty patients undergoing diabetic foot gangrene surgery were randomly divided into two groups,with 40 patients in each.The control group underwent ultrasound-guided nerve block anesthesia,while the observation group received anesthesia with Dex combined on the basis of the control group.The sensory and motor nerve block time of the two groups was compared,along with hemodynamic changes[heart rate(HR),blood oxygen saturation(SpO_(2))]at different time points before and after anesthesia.Serum immune function indicators[CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]before anesthesia and after surgery were measured,and the incidence of adverse reactions was recorded as well.【Results】The onset and completion time of sensory and motor blockade in the observation group were shorter than those in the control group(P<0.05);the duration of sensory and motor blockade in the observation group was longer than that in the control group(P<0.05).The HR after anesthesia in the observation group was significantly higher than that in the control group(P<0.05);the HR at the start of surgery in the observation group was lower than after anesthesia in the same group(P<0.05);the HR after anesthesia in the control group was significantly lower than before anesthesia in the same group(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)after surgery in the control group were significantly lower than before anesthesia in the same group(P<0.05);the levels of CD4^(+)and CD4^(+)/CD8^(+)after surgery in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】The use of Dex combined with ultrasound-guided nerve block anesthesia for diabetic foot gangrene surgery significantly improves the anesthetic effect,effectively prolongs the nerve block ti

关 键 词：糖尿病足/外科学 右美托咪啶/治疗应用 超声检查 坏疽 神经传导阻滞 

分 类 号：R587.2[医药卫生—内分泌]