上海预防医学
上海預防醫學
상해예방의학
SHANGHAI JOURNAL OF PREVENTIVE MEDICINE
2014年
7期
392-394
,共3页
肝部分切除术%腹腔镜%右美托咪定%血流动力学
肝部分切除術%腹腔鏡%右美託咪定%血流動力學
간부분절제술%복강경%우미탁미정%혈류동역학
hepatectomy%laparoscopy Dexmedetomidine%Blood flow dynamics
[目的]探讨不同剂量右美托咪定用于腹腔镜下肝部分切除术的安全性和有效性。[方法]美国麻醉师协会（ ASA）分级为II或Ⅲ级择期行腹腔镜肝部分切除术患者60例，随机分为两组，一组静脉泵注右美托咪定负荷剂量0．2μg/kg（10 min注完），继以0．2μg/（kg· h）维持泵注至手术结束前30 min（D1组），另一组静脉泵注右美托咪定负荷剂量0．2μg/kg（10 min注完），继以0．5μg/（kg· h）维持泵注至手术结束前30 min（D2组）。两组术中用七氟烷、丙泊酚维持麻醉，观察记录输注右美托咪定前（T0）、输注右美托咪定10 min后（T1）、气管插管即刻（T2）、气管插管后1 min（ T3）、气管拔管即刻（ T4）患者的收缩压、舒张压、心率、血氧饱和度，以及术后呼吸恢复时间、睁眼时间、拔管时间和躁动例数。[结果]与入手术室时对比，两组患者在插管前、后和拔管时血压、心率无明显差异， D2组患者术后呼吸恢复时间、睁眼时间、拔管时间均较D1组长（P＜0．05）。[结论]0．2μg/（kg· h）右美托咪定维持泵注可使腹腔镜肝部分切除术患者的血流动力学更稳定，术后苏醒更迅速完全。
[目的]探討不同劑量右美託咪定用于腹腔鏡下肝部分切除術的安全性和有效性。[方法]美國痳醉師協會（ ASA）分級為II或Ⅲ級擇期行腹腔鏡肝部分切除術患者60例，隨機分為兩組，一組靜脈泵註右美託咪定負荷劑量0．2μg/kg（10 min註完），繼以0．2μg/（kg· h）維持泵註至手術結束前30 min（D1組），另一組靜脈泵註右美託咪定負荷劑量0．2μg/kg（10 min註完），繼以0．5μg/（kg· h）維持泵註至手術結束前30 min（D2組）。兩組術中用七氟烷、丙泊酚維持痳醉，觀察記錄輸註右美託咪定前（T0）、輸註右美託咪定10 min後（T1）、氣管插管即刻（T2）、氣管插管後1 min（ T3）、氣管拔管即刻（ T4）患者的收縮壓、舒張壓、心率、血氧飽和度，以及術後呼吸恢複時間、睜眼時間、拔管時間和躁動例數。[結果]與入手術室時對比，兩組患者在插管前、後和拔管時血壓、心率無明顯差異， D2組患者術後呼吸恢複時間、睜眼時間、拔管時間均較D1組長（P＜0．05）。[結論]0．2μg/（kg· h）右美託咪定維持泵註可使腹腔鏡肝部分切除術患者的血流動力學更穩定，術後囌醒更迅速完全。
[목적]탐토불동제량우미탁미정용우복강경하간부분절제술적안전성화유효성。[방법]미국마취사협회（ ASA）분급위II혹Ⅲ급택기행복강경간부분절제술환자60례，수궤분위량조，일조정맥빙주우미탁미정부하제량0．2μg/kg（10 min주완），계이0．2μg/（kg· h）유지빙주지수술결속전30 min（D1조），령일조정맥빙주우미탁미정부하제량0．2μg/kg（10 min주완），계이0．5μg/（kg· h）유지빙주지수술결속전30 min（D2조）。량조술중용칠불완、병박분유지마취，관찰기록수주우미탁미정전（T0）、수주우미탁미정10 min후（T1）、기관삽관즉각（T2）、기관삽관후1 min（ T3）、기관발관즉각（ T4）환자적수축압、서장압、심솔、혈양포화도，이급술후호흡회복시간、정안시간、발관시간화조동례수。[결과]여입수술실시대비，량조환자재삽관전、후화발관시혈압、심솔무명현차이， D2조환자술후호흡회복시간、정안시간、발관시간균교D1조장（P＜0．05）。[결론]0．2μg/（kg· h）우미탁미정유지빙주가사복강경간부분절제술환자적혈류동역학경은정，술후소성경신속완전。
Objective] To explore the safety and effectiveness of Dexmedetomidine ( Dex) at dif-ferent doses used in laparoscopic partial hepatectomy . [ Methods] A total of 60 patients ( ASA II orⅢmagnitude ) who received elective laparoscopic partial hepatectomy were randomly divided into Group D 1 and Group D2.Group D1 received vein pump injection dose of Dex load 0.2 μg/kg (10 min after injec-tion), and was followed by pump injection of 0.2μg/(kg· h) for 30 min before the end of surgery.Group D2 received vein pump injection dose of Dex load 0.2μg/kg (10 min after injection), and was followed by pump injection of 0.5 μg/( kg· h) for 30 min before the end of surgery .The patients in two groups were both given sevoflurane and propofol to maintain anesthesia in surgery and observed and recorded systolic and diastolic pressure ,heart rate ,oxygen saturation of blood ,postoperative respiratory recovery time , eye-open-ing time, extubation time and the number of agitation before infusion with Dexmedetomidine ( T0 ) , at 10 minutes after infusion of Dexmedetomidine ( T1 ) , endotracheal intubation immediately ( T2 ) , 1 min after endotracheal intubation(T3), and endotracheal tube being drawn immediately (T4). [Results] Com-paring with those at the time of entering the operation room , blood pressure and heart rate in the two groups before and after intubation and at the extubation time were not significantly different (P>0.05).The respi-ratorg recovery time ,eye-opening time and extubation time of group D 2 were longer than those of group D 1 (P<0.05). [Conclusion] With maintained pump infusion of Dex at dose of 0.2 μg/(kg· h),pa-tients undergoing laparoscopic partial hepatectomy have more stable hemodynamics and revive more quickly and completely after operation .
