中国保健营养（中旬刊）
中國保健營養（中旬刊）
중국보건영양（중순간）
China Hwalth Care & nutrition
2013年
12期
11-11
,共1页
右美托咪定%全身麻醉%导尿术
右美託咪定%全身痳醉%導尿術
우미탁미정%전신마취%도뇨술
dexmedetomidine%general anesthesia%catheterization
目的：观察右美托咪啶对全麻后留置尿管患者术后早期舒适度的影响。方法：选择100例ASA I~II级行脊柱手术的男性患者随即等分成观察组和对照组。观察组患者于静脉通道建立后静脉给予Dex1ug/kg，采用微量泵注射10min，之后按0.2~0.4 ug.kg-1.h-1持续泵注，并于手术结束前30min停用。对照组给予生理盐水。所有患者均于全麻诱导后行导尿术。麻醉苏醒参考Steward评分，评分在4分及以上者拔除气管导管，并于拔管后5min(T1)，15min (T2)及30min(T3)时进行手术切口舒适度评分、尿路疼痛评分并记录这三个时点平均动脉压（MAP），心率（HR）及SpO2值。结果：两组患者在T1时尿路疼痛满意率无差异，T2、T3时观察组尿路疼痛满意率明显高于对照组,p<0.05。两组患者切口的BCS评分均高，满意例数各时点两组间比较无差异，p>0.05。观察组患者在不同时点MAP无明显变化；T3时HR较T1明显减慢，p<0.01。对照组患者T3时血压较T1明显升高，p<0.01；T2、T3时HR较T1明显增快，p<0.01。组间比较，T2、T3时对照组患者 MAP 和 HR 较观察组有明显变化，p<0.01。SpO2在不同时点均在正常范围内。结论：Dex 能有效地减轻男性患者因全麻后留置尿管引起的尿路疼痛，降低麻醉恢复期间躁动发生率，增加患者舒适度。
目的：觀察右美託咪啶對全痳後留置尿管患者術後早期舒適度的影響。方法：選擇100例ASA I~II級行脊柱手術的男性患者隨即等分成觀察組和對照組。觀察組患者于靜脈通道建立後靜脈給予Dex1ug/kg，採用微量泵註射10min，之後按0.2~0.4 ug.kg-1.h-1持續泵註，併于手術結束前30min停用。對照組給予生理鹽水。所有患者均于全痳誘導後行導尿術。痳醉囌醒參攷Steward評分，評分在4分及以上者拔除氣管導管，併于拔管後5min(T1)，15min (T2)及30min(T3)時進行手術切口舒適度評分、尿路疼痛評分併記錄這三箇時點平均動脈壓（MAP），心率（HR）及SpO2值。結果：兩組患者在T1時尿路疼痛滿意率無差異，T2、T3時觀察組尿路疼痛滿意率明顯高于對照組,p<0.05。兩組患者切口的BCS評分均高，滿意例數各時點兩組間比較無差異，p>0.05。觀察組患者在不同時點MAP無明顯變化；T3時HR較T1明顯減慢，p<0.01。對照組患者T3時血壓較T1明顯升高，p<0.01；T2、T3時HR較T1明顯增快，p<0.01。組間比較，T2、T3時對照組患者 MAP 和 HR 較觀察組有明顯變化，p<0.01。SpO2在不同時點均在正常範圍內。結論：Dex 能有效地減輕男性患者因全痳後留置尿管引起的尿路疼痛，降低痳醉恢複期間躁動髮生率，增加患者舒適度。
목적：관찰우미탁미정대전마후류치뇨관환자술후조기서괄도적영향。방법：선택100례ASA I~II급행척주수술적남성환자수즉등분성관찰조화대조조。관찰조환자우정맥통도건립후정맥급여Dex1ug/kg，채용미량빙주사10min，지후안0.2~0.4 ug.kg-1.h-1지속빙주，병우수술결속전30min정용。대조조급여생리염수。소유환자균우전마유도후행도뇨술。마취소성삼고Steward평분，평분재4분급이상자발제기관도관，병우발관후5min(T1)，15min (T2)급30min(T3)시진행수술절구서괄도평분、뇨로동통평분병기록저삼개시점평균동맥압（MAP），심솔（HR）급SpO2치。결과：량조환자재T1시뇨로동통만의솔무차이，T2、T3시관찰조뇨로동통만의솔명현고우대조조,p<0.05。량조환자절구적BCS평분균고，만의례수각시점량조간비교무차이，p>0.05。관찰조환자재불동시점MAP무명현변화；T3시HR교T1명현감만，p<0.01。대조조환자T3시혈압교T1명현승고，p<0.01；T2、T3시HR교T1명현증쾌，p<0.01。조간비교，T2、T3시대조조환자 MAP 화 HR 교관찰조유명현변화，p<0.01。SpO2재불동시점균재정상범위내。결론：Dex 능유효지감경남성환자인전마후류치뇨관인기적뇨로동통，강저마취회복기간조동발생솔，증가환자서괄도。
Objective:To observe the effect of dexmedetomidine on early postoperative comfort in patients with urinary catheterization. Methods:One hundred male patients underwent spinal surgery, ASA I~II, were equal y divided into observation group and control group. The patients in observation group were intravenously infused Dex1ug/kg within 10min via a pump, and continuous infusion of 0.2~0.4 ug.kg-1.h-1 and were stopped at 30min before the end of surgery. The control group received saline. After the induction of general anesthesia, al patients underwent urinary catheterization. Steward score was referenced and extubation was performed when steward score was more than 4. Comfort rating of surgical incision, pain scores of urinary tract, mean arterial pressure (MAP), heart rate (HR ) and SpO2 values were recorded at 5min (T1), 15min (T2) and 30min after extubation. Results:There was no difference in satisfaction rate of urinary tract pain at T1, however, satisfaction rate in the observation group was higher at T2, T3 ( p<0.05 ). The BCS ratings of patients in both groups were high and there were no difference in satisfaction at each time point between the two groups (p>0.05). There were no significant changes in MAP at different points within the observation group;HR at T3 slowed down than at T1 (p<0.01). The blood pressure at T3 than T1 was significantly higher within control group (p<0.01);HR at T2 or T3 was significantly increased than T1 (p<0.01). There were significant changes in MAP and HR between two groups at T2 and T3 (p<0.01). SpO2 at different points was within the normal range. Conclusion:Dex can effectively reduce urinary tract pain caused by urinary catheterization in male patients after general anesthesia, reduce the rate of agitation during anesthesia recovery, and increase patients’ comfortable degree.
