右美托咪定不同注射方法复合全身麻醉在腹腔镜子宫切除术中的应用效果  

Application Effect of Different Injection Methods of Dexmedetomidine Combined with General Anesthesia in Laparoscopic Hysterectomy

作　　者：孙雪峰 SUN Xuefeng(Department of Anesthesiology,Tianjin Dongli Hospital,Tianjin 300300,China)

机构地区：[1]天津市东丽医院麻醉科,天津300300

出　　处：《中国医学创新》2024年第8期111-116,共6页Medical Innovation of China

摘　　要：目的:探究右美托咪定不同注射方法复合全身麻醉在腹腔镜子宫切除术中的应用效果及安全性。方法:选取2020年10月—2022年10月天津市东丽医院收治的92例接受腹腔镜子宫切除术的患者,使用随机数字表法将其分为三组,A组(n=32)接受全身麻醉,B组(n=30)接受持续泵注右美托咪定,C组(n=30)接受单次注射右美托咪定。对比三组患者入室后(T0)、麻醉后5 min(T_(1))、气管插管(T_(2))、术后即刻(T_(3))、术后24 h(T_(4))血流动力学水平、血糖、纤溶系统指标水平、应激反应,以及麻醉效果、不良反应。结果:T_(1)、T_(2)、T_(3)、T_(4)相较T0,三组HR、MAP均升高,C组T_(1)、T_(2)、T_(3)、T_(4)的HR、MAP均低于B组、A组,B组均低于A组(P<0.05)。C组T_(2)、T_(3)、T_(4)的血糖、D-D、PAI-1、t-PA均低于B组、A组,B组均低于A组(P<0.05)。C组自主呼吸恢复时间、拔管时间、苏醒时间均早于B组、A组,B组均早于A组(P<0.05)。三组不良反应发生率比较,差异有统计学意义(χ^(2)=8.276,P=0.002);A组、B组的不良反应发生率(37.50%、26.67%)均高于C组(6.67%)(P<0.05)。结论:单次注射右美托咪定用于腹腔镜下子宫切除术中,麻醉效果显著,可稳定患者血流动力学,对患者纤溶系统影响较小,降低应激反应,安全性较高。Objective:To explore the efficacy and safety of different injection methods of Dexmedetomidine combined with general anesthesia in laparoscopic hysterectomy.Method:A total of 92 patients undergoing laparoscopic hysterectomy admitted to Tianjin Dongli Hospital from October 2020 to October 2022 were selected,group A(n=32)received general anesthesia,group B(n=30)received continuous pump Dexmedetomidine,and group C(n=30)received a single injection of Dexmedetomidine.The hemodynamic levels,blood glucose and fibrinolytic system indexes,stress response after entry(T0),5 min after anesthesia(T_(1)),tracheal intubation(T_(2)),immediately after surgery(T_(3)),24 h after surgery(T_(4)),anesthesia effect and adverse reactions of the three groups were compared.Result:Compared with T0,HR and MAP of T_(1),T_(2),T_(3) and T_(4) in the three groups were all increased,and HR and MAP of T_(1),T_(2),T_(3) and T_(4) in group C were lower than those in group B and group A,and those in group B were lower than those in group A(P<0.05).The blood glucose levels,D-D,PAI-1 and t-PA at T_(2),T_(3),T_(4) in group C were lower than those in group B and group A,and those in group B were lower than those in group A(P<0.05).The recovery time of spontaneous respiration,extubation time and recovery time of group C were earlier than those of group B and group A,and those in group B were earlier than those in group A(P<0.05).The incidence of adverse reactions among the three groups was statistically significant(χ^(2)=8.276,P=0.002);the incidence of adverse reactions in group A(37.50%)and group B(26.67%)were higher than that in group C(6.67%)(P<0.05).Conclusion:Single injection of Dexmedetomidine in laparoscopic hysterectomy has significant anesthetic effect,can stabilize the hemodynamics of patients,has little impact on the fibrinolytic system of patients,reduces stress response,and is safe.

关 键 词：右美托咪定 不同注射方法 复合全身麻醉 腹腔镜子宫切除术 安全性 

分 类 号：R614.2[医药卫生—麻醉学]