CAJ | 학술논문

【目的】观察右美托咪啶（DEX）在子宫肌瘤高强度聚焦超声（HIFU）治疗术中应用的临床效果。【方法】180例择期行子宫肌瘤HIFU治疗术患者，年龄22～58岁，ASA分级I～II级，随机分为DEX组（D组）和对照组（C组），每组90例。D组于手术前20 min给予DEX负荷剂量0．8μg/kg ，随后以0．2μg/（kg · h）的速率静脉输注至术毕，C组给予等容量0．9％氯化钠溶液。手术开始前及手术中根据OAA/S镇静评分、VAS镇痛评分予静脉注射咪达唑仑、芬太尼，比较两组患者咪达唑仑、芬太尼的用量，呼吸抑制及麻醉满意度（ISAS 评分）情况。【结果】D组与C组分别有59例（65．6％）和90例（100％）需要加用咪达唑仑，用量分别为（1．05±0．52）mg和（3．68±0．96）mg，D组用量少于C组（P ＜0．05）。所有患者均需追加芬太尼，D组与C组用量分别为（0．13±0．09）m g和（0．18±0．08）m g ，D组用量少于C组（ P ＜0．05）。D组有9例出现心动过缓，C组有4例，D组心动过缓发生率高于C组（ P＜0．05）。D组高血压、心动过速、呼吸抑制发生率明显低于C组（ P ＜0．05），D组ISAS评分高于C组（ P ＜0．05）。【结论】 DEX在子宫肌瘤患者 HIFU 治疗手术中可以减少咪达唑仑及芬太尼用量，减少呼吸抑制的发生，提高患者麻醉满意度。
【목적】관찰우미탁미정（DEX）재자궁기류고강도취초초성（HIFU）치료술중응용적림상효과。【방법】180례택기행자궁기류HIFU치료술환자，년령22～58세，ASA분급I～II급，수궤분위DEX조（D조）화대조조（C조），매조90례。D조우수술전20 min급여DEX부하제량0．8μg/kg ，수후이0．2μg/（kg · h）적속솔정맥수주지술필，C조급여등용량0．9％록화납용액。수술개시전급수술중근거OAA/S진정평분、VAS진통평분여정맥주사미체서륜、분태니，비교량조환자미체서륜、분태니적용량，호흡억제급마취만의도（ISAS 평분）정황。【결과】D조여C조분별유59례（65．6％）화90례（100％）수요가용미체서륜，용량분별위（1．05±0．52）mg화（3．68±0．96）mg，D조용량소우C조（P ＜0．05）。소유환자균수추가분태니，D조여C조용량분별위（0．13±0．09）m g화（0．18±0．08）m g ，D조용량소우C조（ P ＜0．05）。D조유9례출현심동과완，C조유4례，D조심동과완발생솔고우C조（ P＜0．05）。D조고혈압、심동과속、호흡억제발생솔명현저우C조（ P ＜0．05），D조ISAS평분고우C조（ P ＜0．05）。【결론】 DEX재자궁기류환자 HIFU 치료수술중가이감소미체서륜급분태니용량，감소호흡억제적발생，제고환자마취만의도。
[Objective]To observe the clinical efficacy of dexmedetomidine(DEX) in high intensity focused ul-trasound(HIFU) treatment for patients with hysteromyoma .[Methods]Totally 180 ASA Ⅰ ~ Ⅱ patients(aged 22~58 years old) with hysteromyoma scheduled for HIFU treatment were randomly divided into DEX group (group D ,n =90) and control group(group C ,n=90) .Group D was given intravenous infusion of DEX by 0 .2μg/(Kg . h) until the end of operation after a loading dose of 0 .8μg/kg at 20min before operation .Group C was infused with equal volume of 09% normal saline .According to OAA/A sedation score and VAS analgesia score ,midazolam and fentanyl were intravenously injected before and during the operation .The dosage of midazolam and fentanyl ,re-spiratory depression and anesthesia satisfaction (ISAS score) were compared between two groups .[Results] Mid-azolam was required in 58 patients (65 .6% ) in group D and 90 patients (100% ) in group C ,and the dose was (1 .05 ± 0 .52)mg and (3 .68 ± 0 .96)mg ,respectively .The dose of midazolam in group D was lower than that in group C( P <0 .05) .All patients additionally required fentanyl ,and the dose was (0 .13 ± 0 .09)mg and (0 .18 ± 0 .08)mg ,respectively .The dose of fentanyl in group D was lower than that in group C ( P < 0 .05) .The inci-dence of tachycardia in group D was higher than that in group C ( P <0 .05) ,while the incidence of hypertension and respiratory depression in group D was lower that in group C ( P <0 .05) .ISAS score in group D was higher than that in group C( P <0 .05) .[Conclusion]DEX used in HIFU treatment of patients with hysteromyoma can reduce the dose of midazolam and fentanyl ,decrease the incidence of respiratory depression and increase anesthesia satisfaction of patients .