右美托咪定在单孔胸腔镜肺癌根治术中的应用效果分析  

Comparison of practical effects of dexmedetomidine in single-port thoracoscopic radical resection of lung cancer

作　　者：于霜霜 祖明龙 徐诺 张林 朱映锟 韩玉湘[1] YU Shuang-shuang;ZU Ming-long;XU Nuo(The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519099,China)

机构地区：[1]中山大学附属第五医院,519099

出　　处：《中国实用医药》2024年第7期18-22,共5页China Practical Medicine

摘　　要：目的分析右美托咪定在单孔胸腔镜肺癌根治术中的应用效果。方法选取100例行单孔胸腔镜肺癌根治术的患者,根据术中麻醉用药情况分为对照组(未使用右美托咪定)和实验组(使用右美托咪定),每组50例。对照组术中使用瑞芬太尼复合七氟烷麻醉,实验组术中使用右美托咪定、瑞芬太尼复合七氟烷麻醉。比较两组患者术前到术后共11个时间点血压、心率的波动情况,苏醒情况,术前、术后空腹血糖变化情况;观察两组患者并发症发生情况及追加药物情况。结果①与本组术前(T1)比较,两组患者麻醉开始前(T2)收缩压显著升高(P<0.05)。②两组患者术后第1天(T11)舒张压低于本组T1时(P<0.05)。③麻醉开始后60 min(T4),实验组患者心率低于对照组(P<0.05)。④两组患者拔管时间、拔管后苏醒时间、总苏醒时间比较均无显著差异(P>0.05)。两组患者在麻醉后监测治疗室(PACU)的Steward评分均达到6分,安全送返普通病房。⑤两组术前、术后空腹血糖及血糖变化差值组间比较无显著差异(P>0.05);两组术后空腹血糖均高于本组术前(P<0.05)。⑥两组患者术后在PACU苏醒期间均无严重并发症发生,均未发生患者PACU停留时间>2 h情况。结论右美托咪定、瑞芬太尼复合七氟烷麻醉在单孔胸腔镜肺癌根治术中应用可以降低患者术中心率,其余循环指标、苏醒质量无显著差异,术后血糖较术前显著增高,但与瑞芬太尼复合七氟烷麻醉无显著差异。Objective To analyze the practical effects of dexmedetomidine in single-port thoracoscopic radical resection of lung cancer.Methods A total of 100 patients who underwent single-port thoracoscopic radical resection of lung cancer were selected and divided into the control group(without dexmedetomidine)and the experimental group(with dexmedetomidine)according to the intraoperative anesthesia,with 50 cases in each group.The control group was anesthetized with remifentanil combined with sevoflurane,while the experimental group was anesthetized with dexmedetomidine and remifentanil combined with sevoflurane.The variations of blood pressure and heart rate at 11 time points from preoperative to postoperative,recovery conditions and the changes of fasting blood glucose before and after surgery were compared between the two groups.The occurrence of complications and the use of additional drugs in the two groups were observed.Results a.Compared with the day before surgery(T1)of the same group,the systolic blood pressure before anesthesia(T2)was significantly increased for the two groups(P<0.05).b.On the first day after surgery(T11),the diastolic blood pressure of the two groups of patients was lower than that of this group at T1(P<0.05).c.At 60 min after anesthesia(T4),the heart rate of the patients in the experimental group was lower than that in the control group(P<0.05).d.There were no significant differences in extubation time,recovery time after extubation and total recovery time between the two groups(P>0.05).The Steward score of both groups reached 6 points in the post-anesthesia care unit(PACU),and the patients were safely returned to the general ward.e.There were no significant differences in the changes of fasting blood glucose before and after surgery between the two groups(P>0.05).The fasting blood glucose after surgery in both groups was higher than that before surgery(P<0.05).f.There were no serious complications during recovery in PACU in both groups after surgery,and there was no case that PACU stayed for m

关 键 词：右美托咪定 单孔胸腔镜肺癌根治术 应激反应 血流动力学变化 苏醒质量 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]