中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2014年
11期
15-16
,共2页
盐酸右美托咪定%镇静%血糖
鹽痠右美託咪定%鎮靜%血糖
염산우미탁미정%진정%혈당
Dexmedetomidine%Sedation%Blood sugar
目的：探讨盐酸右美托咪定在骨科手术中的临床应用。方法90例患者选择硬膜外麻醉的骨科手术，随机分为对照组（C组）、右美托咪定组（D组）和丙泊酚组（P组）。三组患者均接受利罗合剂（1%利多卡因和0.5%罗哌卡因）连续硬膜外麻醉。观察并记录给药前（T0）、切皮前即用药后15 min（T1）、45 min（T2）、术毕（T3）时的心率(HR)、平均动脉压（MAP）、Ramsay镇静评分，并同时测定血糖。结果 C组在T1、T2和T3时间点HR和MAP明显高于D组和P组，Ramsay镇静评分低于D组和P组(P<0.05)；D组和P组在T1、T2和T3时MAP明显低于T0（P<0.05)，T1时Ramsay镇静评分高于T0（P<0.05)；D组在T1、T2和T3时HR明显低于T0。与T0点相比， C组在T1、T2时点血糖升高，且高于D组和P组(P<0.05)。结论盐酸右美托咪定能够对清醒的患者提供良好镇静作用，降低围术期手术患者的血糖，抑制机体的应激反应。
目的：探討鹽痠右美託咪定在骨科手術中的臨床應用。方法90例患者選擇硬膜外痳醉的骨科手術，隨機分為對照組（C組）、右美託咪定組（D組）和丙泊酚組（P組）。三組患者均接受利囉閤劑（1%利多卡因和0.5%囉哌卡因）連續硬膜外痳醉。觀察併記錄給藥前（T0）、切皮前即用藥後15 min（T1）、45 min（T2）、術畢（T3）時的心率(HR)、平均動脈壓（MAP）、Ramsay鎮靜評分，併同時測定血糖。結果 C組在T1、T2和T3時間點HR和MAP明顯高于D組和P組，Ramsay鎮靜評分低于D組和P組(P<0.05)；D組和P組在T1、T2和T3時MAP明顯低于T0（P<0.05)，T1時Ramsay鎮靜評分高于T0（P<0.05)；D組在T1、T2和T3時HR明顯低于T0。與T0點相比， C組在T1、T2時點血糖升高，且高于D組和P組(P<0.05)。結論鹽痠右美託咪定能夠對清醒的患者提供良好鎮靜作用，降低圍術期手術患者的血糖，抑製機體的應激反應。
목적：탐토염산우미탁미정재골과수술중적림상응용。방법90례환자선택경막외마취적골과수술，수궤분위대조조（C조）、우미탁미정조（D조）화병박분조（P조）。삼조환자균접수리라합제（1%리다잡인화0.5%라고잡인）련속경막외마취。관찰병기록급약전（T0）、절피전즉용약후15 min（T1）、45 min（T2）、술필（T3）시적심솔(HR)、평균동맥압（MAP）、Ramsay진정평분，병동시측정혈당。결과 C조재T1、T2화T3시간점HR화MAP명현고우D조화P조，Ramsay진정평분저우D조화P조(P<0.05)；D조화P조재T1、T2화T3시MAP명현저우T0（P<0.05)，T1시Ramsay진정평분고우T0（P<0.05)；D조재T1、T2화T3시HR명현저우T0。여T0점상비， C조재T1、T2시점혈당승고，차고우D조화P조(P<0.05)。결론염산우미탁미정능구대청성적환자제공량호진정작용，강저위술기수술환자적혈당，억제궤체적응격반응。
Objective To discuss application of dexmedetomidine during epidural anesthesia in orthopaedic surgery. Methods Ninety patients of selective operation undergoing orthopaedic surgery in epidural anesthesia were randomLy divided into three groups:control group(group C), dexmedetomidine group (group D) and propofol group (group P). All patients received low epidural anesthesia with 1%lidocaine and 0.5%ropivacaine hudrochloride. MAP, HR, Ramsay scores, blood sugar were recorded at the time of before administration (T0), before incision(T1), 45 min (T2) after operation start, when operation ifnished(T3). Results Compared with group C, MAP and HR were decreased at T1, T2 and T3 in group D and group P, Ramsay scores were increased in group D and group P (P<0.05). Compared with T0, MAP were decreased at T1, T2 and T3 in group D and group P, Ramsay scores were increased at T1 in group D and group P (P<0.05). Compared with T0, HR were decreased at T1, T2 and T3 in group D (P<0.05). Compared with group D and group P, blood sugar was increased at T1 and T2 in group C (P<0.05). Conclusion With using dexmedetomidine, patients with conscious will get good sedative effect in orthopaedic surgery under epidural anesthesia. Using dexmedetomidine can decreased the blood sugar in patients in surgery and inhibit the body's stress response.
