右美托咪定在尘肺患者行大容量全肺灌洗术苏醒期的临床疗效评估  

Evaluation of clinical efficacy of dexmedetomidine in the recovery period of large volume whole-lung lavage in patients with pneumoconiosis

作　　者：李玲苇 钟庆华 陈林 刘绮 龚享文 LI Lingwei;ZHONG Qinghua;CHEN Lin;LIU Qi;GONG Xiangwen(Department of Anesthesiology,The Fifth People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China;Department of Respiratory Medicine,The Fifth People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市第五人民医院麻醉科,江西赣州341000 [2]赣州市第五人民医院呼吸内科,江西赣州341000

出　　处：《当代医学》2024年第19期99-103,共5页Contemporary Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF309)。

摘　　要：目的评估右美托咪定在尘肺患者行大容量全肺灌洗术苏醒期的临床疗效。方法选取2021年1月至2022年12月于赣州市第五人民医院行大容量支气管肺泡灌洗术治疗的80例男性尘肺病患者作为研究对象,随机分为观察组与对照组,每组40例。两组均给予大容量全肺灌洗术,观察组麻醉诱导前15 min给予负荷剂量的右美托咪定1μg/kg静脉持续泵注,并在麻醉维持期予0.5ug/(kg·h)静脉泵注至灌洗完毕。对照组静脉注射等量0.9%氯化钠溶液。比较两组麻醉诱导前(T0)、灌洗结束停用所有麻醉药物时(T1)、拔管时(T2)、拔管后5 min(T3)、拔管后15 min(T4)、拔管后30 min(T5)的平均动脉压(mean arterial pressure,MAP)和心率(heart rate,HR)、苏醒状况(改良Aldrete评分)及躁动镇静情况[Richmond躁动-镇静评分(richmond agitation and sedation scale,RASS)]、拔管时呛咳反应评分、不良事件发生情况。结果T0、T4、T5时,两组MAP、HR比较差异无统计学意义;T1~T3时,观察组MAP、HR均低于对照组,差异有统计学意义(P<0.05)。T3时,观察组改良Aldrete评分低于对照组,差异有统计学意义(P<0.05);T4、T5时,两组改良Aldrete评分比较差异无统计学意义。T2~T4时,观察组RASS评分低于对照组,差异有统计学意义(P<0.05)。观察组呛咳反应评分、术后恶心呕吐发生率低于对照组,差异有统计学意义(P<0.05),两组低血压、心动过缓发生率比较差异无统计学意义。结论右美托咪定在大容量全肺灌洗术尘肺病患者麻醉苏醒期使用期间的血流动力学更加稳定,呛咳反应和术后恶心呕吐等发生率更低,且不影响患者苏醒及拔管时间。Objective To evaluate the clinical efficacy of dexmedetomidine in the recovery period of large volume whole-lung lavage in patients with pneumoconiosis.Methods A total of 80 male patients with pneumoconiosis who underwent large volume bronchoalveolar lavage in The Fifth People's Hospital of Ganzhou from January 2021 to December 2022 were selected as the research subjects,they were randomly divided into the observation group and the control group,with 40 cases in each group.Both groups were given large volume whole-lung lavage,and the observation group was given continuous intravenous pumping of loading dose of 1μg/kg of dexmedetomidine at 15 min before anesthesia induction,and intravenous pumping of 0.5μg/(kg·h)during anesthesia maintenance until the end of lavage,while the control group was intravenously injected with the same amount of 0.9%sodium chloride solution.The mean arterial pressure(MAP)and heart rate(HR)before anesthesia induction(T0),at the time of anaesthetic withdrawal at the end of lavage(T1),at extubation(T2),at 5 min after extubation(T3),at 15 min after extubation(T4)and at 30 min after extubation(T5),recovery status(the modified Aldrete score),agitation and sedation(Richmond agitation and sedation scale[RASS],bucking response score at extubation,and occurrence of adverse events were compared between the two groups.Results At T0,T4 and T5,there was no significant difference in MAP and HR between the two groups.At T1-T3,MAP and HR in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At T3,the modified Aldrete score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).At T4 and T5,there was no significant difference in the modified Aldrete score between the two groups.At T2-T4,the RASS score in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The cough response score and the inciden

关 键 词：右美托咪定 尘肺病 大容量全肺灌洗术 苏醒期 

分 类 号：R614[医药卫生—麻醉学]