右美托咪定联合咪达唑仑对经皮肾镜碎石术患者血流动力学及肾功能影响  

Effect of dexmedetomidine combined with midazolam on hemodynamic and renal function in patients undergoing percutaneous nephrolithotomy

作　　者：覃向全 黄志远 陈霜[1] 覃学进 罗春雷 蓝英年[1] Qin Xiangquan;Huang Zhiyuan;Chen Shuang;Qin Xuejin;Luo Chunlei;Lan Yingnian(Anesthesiology Department of Hechi People's Hospital,Hechi,Guang Xi 547000,China)

机构地区：[1]河池市人民医院麻醉科,广西河池547000 [2]河池市人民医院泌尿外科,广西河池547000

出　　处：《泌尿外科杂志(电子版)》2025年第1期86-89,共4页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的探讨右美托咪定联合咪达唑仑对经皮肾镜碎石术(percutaneous nephrolithotripsy,PCNL)患者血流动力学及肾功能影响。方法选取2022年1月至2024年1月河池市人民医院收治的80例PCNL患者作为研究对象,按照信封随机分组法分为对照组和观察组,对照组采用咪达唑仑麻醉、观察组采用右美托咪定联合咪达唑仑麻醉,每组40例。记录并比较两组血流动力学,肾功能指标和安全性差异。结果入室后(T0),两组平均动脉压(mean arterial pressur,MAP)、心率(heart rate,HR)、血氧饱和度(oxygen saturation,SpO_(2))水平比较,差异无统计学意义(P>0.05);麻醉10 min(T1)至术毕(T3),两组MAP、HR、SpO_(2)水平均低于入室后,差异有统计学意义(P<0.05);麻醉10 min(T1)至术毕(T3)观察组各项指标均水平高于对照组,差异有统计学意义(P<0.05)。术后3 d,两组血肌酐(serum creatinine,Scr)、胱抑素C(cystatin C,CysC)、尿素氮(blood urea nitrogen,BUN)水平均较术前升高,但观察组更低(P<0.05),差异有统计学意义。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咪达唑仑能有效稳定PCNL术患者血流动力学,减轻肾功能损伤,且安全性较好。Objective To investigate the effects of dexmedetomidine combined with midazolam on hemodynamicand renal function in patients undergoing percutaneous nephrolithotomy(PCNL).Method Totally 80 PCNL patients admitted to Hechi People's Hospital from January 2022 to January 2024 were randomly divided into two groups using envelope randomization.The control group was anesthetized with midazolam,while the observation group was anesthetized with dexmedetomidine combined with midazolam,with 40 patients in each group.The differences in hemodynamics,renal function indicators,and safety between two groups were recorded and compared.Result After entering the room(T0),there were no differences in the levels of mean arterial pressure(MAP),heart rate(HR),and oxygen saturation(SpO_(2))between the two groups(P>0.05):From anesthesia for 10 minutes(T1)to the end of surgery(T3),the levels of MAP,HR,and SpO_(2) in both groups were lower than those after entering the room(P<0.05);the levels of various indicators in the observation group were higher than those in the control group from 10 minutes of anesthesia(T1)to the end of surgery(T3)(P<0.05).Three days after surgery,the levels of serum creatinine(Scr),cystatin C(CysC),and blood urea nitrogen(BUN)in both groups increased compared to preoperative levels,but the observation group had lower levels(P<0.05).There was no statistically significant diference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of dexmedetomidine and midazolam can effectively stabilize the hemodynamics of PCNL patients,reduce renal function damage,and has good safety.

关 键 词：经皮肾镜碎石术 右美托咪定联合咪达唑仑 血流动学 肾功能 

分 类 号：R692.4[医药卫生—泌尿科学]