右美托咪定联合全身麻醉在髋骨骨折手术患者中的应用效果  

Application effects of Dexmedetomidine combined with general anesthesia in patients undergoing hip fracture surgery

作　　者：罗书涵 LUO Shuhan(Anesthesiology Department of Xi County People’s Hospital,Xinyang 464300 Henan,China)

机构地区：[1]息县人民医院麻醉科,河南信阳464300

出　　处：《中国民康医学》2024年第19期55-57,70,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察右美托咪定联合全身麻醉在髋骨骨折手术患者中的应用效果。方法:回顾性分析2021年6月至2023年5月在该院行手术治疗的68例髋骨骨折患者的临床资料,根据麻醉方案不同将其分为对照组(n=34)和研究组(n=34)。对照组行全身麻醉,研究组在对照组基础上联用右美托咪定,比较两组不同时刻[术前(T_(0))、麻醉后15 min(T_(1))、麻醉后30 min(T_(2))、麻醉后60 min(T_(3))]血流动力学指标(平均动脉压、心率)水平、不同时刻镇静程度评分、手术前后[T_(0)、术毕时(T_(4))]应激反应指标[肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)]水平和术后48 h内不良反应发生率。结果:T_(2)、T_(3)时,两组心率水平均低于T_(0)时,T_(1)、T_(2)、T_(3)时,两组平均动脉压水平均低于T_(0)时,但研究组高于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时,研究组Ramsay镇静评分均高于对照组,差异有统计学意义(P<0.05);T_(3)时,两组Ramsay镇静评分比较,差异无统计学意义(P>0.05);T_(4)时,两组血清E、NE、Cor水平均高于T_(0)时,但研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定联合全身麻醉可提高髋骨骨折手术患者镇静评分,稳定血流动力学指标水平,降低应激反应指标水平,效果优于单纯全身麻醉。Objective:To observe application effects of Dexmedetomidine combined with general anesthesia in patients undergoing hip fracture surgery.Methods:The clinical data of 68 patients with hip fracture who underwent surgical treatment in this hospital from June 2021 to May 2023 were retrospectively analyzed.According to different anesthesia schemes,they were divided into control group(n=34)and study group(n=34).The control group underwent general anesthesia,while the study group was combined with Dexmedetomidine on the basis of that of the control group.The levels of hemodynamic indexes(mean arterial pressure,heart rate)at different times[preoperative(T_(0)),15 min after anesthesia(T_(1)),30 min after anesthesia(T_(2)),60 min after anesthesia(T_(3))],the scores of sedation at different times,the levels of stress response indexes[epinephrine(E),norepinephrine(NE),cortisol(Cor)]before and after the surgery[T_(0),end of surgery(T_(4))]and the incidence of adverse reactions within 48 h after the surgery were compared between the two groups.Results:At T_(2) and T_(3),the heart rate levels of the two groups were lower than those at T_(0);at T_(1),T_(2) and T_(3),the mean arterial pressure levels of the two groups were lower than those at T_(0),but those in the study group were higher than those in the control group;and the differences were statistically significant(P<0.05).At T_(1) and T_(2),the Ramsay sedation scores of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).At T_(3),there was no significant difference in the Ramsay sedation score between the two groups(P>0.05).At T_(4),the levels of serum E,NE and Cor in the two groups were higher than those at T_(0),but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Dexmedetomidine combined with general anesthesia ca

关 键 词：右美托咪定 全身麻醉 髋骨骨折 镇静 应激 血流动力学 不良反应 

分 类 号：R614[医药卫生—麻醉学]