中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
26期
21-23
,共3页
椎体成形术%老年人%右美托咪定%镇静
椎體成形術%老年人%右美託咪定%鎮靜
추체성형술%노년인%우미탁미정%진정
Kyphoplasty%Aged%Dexmedetomidine%Sedation
目的 观察小剂量右美托咪定(DEX)在老年椎体后凸成形术(PKP)中的镇静效果.方法 将40例ASA分级Ⅱ～Ⅲ级择期行PKP的老年患者(年龄≥65岁)按随机数字表法分为DEX组和对照组,每组20例.DEX组于手术开始前10 min输注DEX,负荷剂量为0.5μg/kg,10 min后改为0.2μg/(kg·h);对照组输注等容量0.9％氯化钠.记录给药即刻(T0),给药后l0 min(T1)、30 min(T2)、60 min (T3)及术毕(T4)时收缩压、舒张压、心率、脉搏血氧饱和度(SpO2)的变化,同时记录Ramsay评分,并进行比较.结果 DEX组T1～T3心率、收缩压、舒张压均低于本组T0和同期对照组[(65.6±14.6)、(63.4±10.2)、(66.7±10.5)次/min比(81.4±11.2)次/min和(75.3±6.9)、(72.8±11.4)、(73.8±9.6),(127.5±10.2)、(125.4±12.6)、(122.4±7.8) mm Hg(1 mm Hg =0.133 kPa)比(152.5±11.8) mm Hg和(145.1±10.6)、(137.2±11.3)、(142.6±8.8) mm Hg,(73.7±8.9)、(70.3±9.9)、(70.3±11.5) mmHg比(90.5±11.0) mm Hg和(86.2±11.6)、(82.6±10.9)、(78.8±8.7) mm Hg],Ramsay评分均高于本组T0和同期对照组[(3.6±0.8)、(4.2±0.8)、(3.7±0.5)分比(2.0±0.0)分和(1.7±0.6)、(1.9±0.4)、(1.6±0.5)分],DEX组T4心率、收缩压、舒张压仍明显低于本组T0,DEX组T4心率还低于同期对照组,差异均有统计学意义(P＜0.05).全部患者均未发生心动过缓以及应用升压药.两组SpO2比较差异无统计学意义(P＞0.05).结论 小剂量DEX用于老年患者PKP中的镇静效果良好、安全可行.
目的 觀察小劑量右美託咪定(DEX)在老年椎體後凸成形術(PKP)中的鎮靜效果.方法 將40例ASA分級Ⅱ～Ⅲ級擇期行PKP的老年患者(年齡≥65歲)按隨機數字錶法分為DEX組和對照組,每組20例.DEX組于手術開始前10 min輸註DEX,負荷劑量為0.5μg/kg,10 min後改為0.2μg/(kg·h);對照組輸註等容量0.9％氯化鈉.記錄給藥即刻(T0),給藥後l0 min(T1)、30 min(T2)、60 min (T3)及術畢(T4)時收縮壓、舒張壓、心率、脈搏血氧飽和度(SpO2)的變化,同時記錄Ramsay評分,併進行比較.結果 DEX組T1～T3心率、收縮壓、舒張壓均低于本組T0和同期對照組[(65.6±14.6)、(63.4±10.2)、(66.7±10.5)次/min比(81.4±11.2)次/min和(75.3±6.9)、(72.8±11.4)、(73.8±9.6),(127.5±10.2)、(125.4±12.6)、(122.4±7.8) mm Hg(1 mm Hg =0.133 kPa)比(152.5±11.8) mm Hg和(145.1±10.6)、(137.2±11.3)、(142.6±8.8) mm Hg,(73.7±8.9)、(70.3±9.9)、(70.3±11.5) mmHg比(90.5±11.0) mm Hg和(86.2±11.6)、(82.6±10.9)、(78.8±8.7) mm Hg],Ramsay評分均高于本組T0和同期對照組[(3.6±0.8)、(4.2±0.8)、(3.7±0.5)分比(2.0±0.0)分和(1.7±0.6)、(1.9±0.4)、(1.6±0.5)分],DEX組T4心率、收縮壓、舒張壓仍明顯低于本組T0,DEX組T4心率還低于同期對照組,差異均有統計學意義(P＜0.05).全部患者均未髮生心動過緩以及應用升壓藥.兩組SpO2比較差異無統計學意義(P＞0.05).結論 小劑量DEX用于老年患者PKP中的鎮靜效果良好、安全可行.
목적 관찰소제량우미탁미정(DEX)재노년추체후철성형술(PKP)중적진정효과.방법 장40례ASA분급Ⅱ～Ⅲ급택기행PKP적노년환자(년령≥65세)안수궤수자표법분위DEX조화대조조,매조20례.DEX조우수술개시전10 min수주DEX,부하제량위0.5μg/kg,10 min후개위0.2μg/(kg·h);대조조수주등용량0.9％록화납.기록급약즉각(T0),급약후l0 min(T1)、30 min(T2)、60 min (T3)급술필(T4)시수축압、서장압、심솔、맥박혈양포화도(SpO2)적변화,동시기록Ramsay평분,병진행비교.결과 DEX조T1～T3심솔、수축압、서장압균저우본조T0화동기대조조[(65.6±14.6)、(63.4±10.2)、(66.7±10.5)차/min비(81.4±11.2)차/min화(75.3±6.9)、(72.8±11.4)、(73.8±9.6),(127.5±10.2)、(125.4±12.6)、(122.4±7.8) mm Hg(1 mm Hg =0.133 kPa)비(152.5±11.8) mm Hg화(145.1±10.6)、(137.2±11.3)、(142.6±8.8) mm Hg,(73.7±8.9)、(70.3±9.9)、(70.3±11.5) mmHg비(90.5±11.0) mm Hg화(86.2±11.6)、(82.6±10.9)、(78.8±8.7) mm Hg],Ramsay평분균고우본조T0화동기대조조[(3.6±0.8)、(4.2±0.8)、(3.7±0.5)분비(2.0±0.0)분화(1.7±0.6)、(1.9±0.4)、(1.6±0.5)분],DEX조T4심솔、수축압、서장압잉명현저우본조T0,DEX조T4심솔환저우동기대조조,차이균유통계학의의(P＜0.05).전부환자균미발생심동과완이급응용승압약.량조SpO2비교차이무통계학의의(P＞0.05).결론 소제량DEX용우노년환자PKP중적진정효과량호、안전가행.
Objective To explore the sedative effects of a low dose of dexmedetomidine (DEX) during percutaneous kyphoplasty (PKP) in the elderly patients.Methods Forty elderly patients with ASA grade Ⅱ-Ⅲ grade who scheduled PKP were divided into DEX group and control group by random digits table method,each group 20 cases.DEX group received an infusion of 0.5 μg/kg for 10 min before the operation,then the infusion speed was adjusted to 0.2 μ g/ (kg·h).An equivalent volume of 0.9％ sodium chloride was administered in control group.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate (HR),and pulse oxygen saturation (SpO2) were recorded at the beginning of DEX infusion (T0),10 min(T1),30 min(T2),60 min(T3) after DEX infusion and the end of operation (T4),Ramsay scores was also recorded.Results HR,SBP,DBP in DEX group at T1-T3 was significantly lower than that T0 and the same time in control group [(65.6 ± 14.6),(63.4 ± 10.2),(66.7 ± 10.5) times/min vs.(81.4 ± 11.2) times/min and (75.3 ±6.9),(72.8 ± 11.4),(73.8 ±9.6) times/min; (127.5 ± 10.2),(125.4 ± 12.6),(122.4 ±7.8) mm Hg(1 mm Hg =0.133 kPa) vs.(152.5 ± 11.8) mm Hg and(145.1 ± 10.6),(137.2 ± 11.3),(142.6 ± 8.8) mm Hg; (73.7 ± 8.9),(70.3 ± 9.9),(70.3 ± 11.5) mm Hg vs.(90.5 ± 11.0) mm Hg and(86.2 ± 11.6),(82.6 ± 10.9),(78.8 ±8.7) mm Hg,P ＜0.05].The Ramsay scores in DEX group at T1-T3 were significantly higher than those T0 and the same time in control group [(3.6 ± 0.8),(4.2 ± 0.8),(3.7 ± 0.5) scores vs.(2.0 ± 0.0)scores and (1.7 ± 0.6),(1.9 ± 0.4),(1.6 ± 0.5) scores,P ＜ 0.05].HR,SBP,DBP in DEX group at T4 was significantly lower than that T0,HR in DEX group at T4 was significandy lower than that in control group,difference was statistically significant(P ＜ 0.05).Bradycardia and applications vasopressors did not occur in two groups.There was no significant difference in SpO2 between DEX group and control group(P＞ 0.05).Conclusion It is both feasible and safe that sedative effect of a small dose of DEX during PKP in the elderly patients.
