CAJ | 학술논문

目的：探讨静注右美托咪啶对预防瑞芬太尼引起的呛咳反应和诱导前后血流动力学的影响。方法：随机选择我院麻醉前ASA评分为I-II级的需进行择期手术的患者145例，随机将其分为两组：观察组73例，静注右美托咪啶后静注瑞芬太尼进行诱导麻醉；对照组：72例，静注生理盐水后静注瑞芬太尼进行诱导麻醉。比较两组之间的呛咳反应的程度与发生率、诱导前后心率、收缩压、舒张压及平均动脉压之间的变化差异。结果：观察组在瑞芬太尼静注30s后的呛咳反应发生率为21．92％，显著低于对照组，差异有统计学意义（ P＜0．05）；观察组在静注右美托咪啶后心率减慢、血压升高，明显优于静注右美托咪啶前，差异有统计学意义（ P＜0．05）；观察组静注右美托咪啶后心率减慢、血压升高明显优于对照组，差异有统计意义（ P＜0．05）。结论：静注右美托咪啶有效减少瑞芬太尼引起的呛咳反应的发生率并可使血流动力学稳定，值得临床推广使用。
목적：탐토정주우미탁미정대예방서분태니인기적창해반응화유도전후혈류동역학적영향。방법：수궤선택아원마취전ASA평분위I-II급적수진행택기수술적환자145례，수궤장기분위량조：관찰조73례，정주우미탁미정후정주서분태니진행유도마취；대조조：72례，정주생리염수후정주서분태니진행유도마취。비교량조지간적창해반응적정도여발생솔、유도전후심솔、수축압、서장압급평균동맥압지간적변화차이。결과：관찰조재서분태니정주30s후적창해반응발생솔위21．92％，현저저우대조조，차이유통계학의의（ P＜0．05）；관찰조재정주우미탁미정후심솔감만、혈압승고，명현우우정주우미탁미정전，차이유통계학의의（ P＜0．05）；관찰조정주우미탁미정후심솔감만、혈압승고명현우우대조조，차이유통계의의（ P＜0．05）。결론：정주우미탁미정유효감소서분태니인기적창해반응적발생솔병가사혈류동역학은정，치득림상추엄사용。
Objective:To observe the effects of dexmedetomidine on haemodynamics and choking cough response caused by remifentanil .Method:145 patients in level ASA I orⅡwere selected and divided into two groups randomly:observation group ( n=73) with dexmedetomidine and Remifentanil I .V.Control group ( n=72) with normal saline ( NS) and Remifentanil I .V.Choking cough reaction degree and incidence and heart rate ,SBP ,DBP and MAP were compared .Result: Choking cough response rates of observation group was less than that in control group , There's significant difference between the patients of two groups ( P<0. 05);Dexmedetomidine intravenous injection decreased heart rate and elevation of blood pressure more than control group, There's significant difference between the patients of two groups (P<0.05);After dexmedeto-midine intravenous injection decreased heart rate and elevation of blood pressure more than before dexme -detomidine intravenous injection , There's significant difference between the two groups of patients ( P<0.05) . Conclusion:Dexmedetomidine is effective in lessening choking cough response caused by remifentaniland stabilizing haemodynamics .