浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2014年
19期
1642-1644
,共3页
贾宝河%王克宇%刘巨斌%滕金亮
賈寶河%王剋宇%劉巨斌%滕金亮
가보하%왕극우%류거빈%등금량
盐酸右美托咪啶%妇科%腹腔镜手术%心血管反应
鹽痠右美託咪啶%婦科%腹腔鏡手術%心血管反應
염산우미탁미정%부과%복강경수술%심혈관반응
Dexmedetomidine%Department of gynaecology%Laparoscopic surgery%Cardio- vascular response
目的：探讨盐酸右美托咪啶对妇科腹腔镜术中全麻患者心血管反应的预防作用。方法将择期妇科腹腔镜手术全麻患者70例，采用随机数字表法分为盐酸右美托咪啶治疗组（A组）和对照组（B组），各35例。A组于气管插管诱导前10min静脉泵注盐酸右美托咪啶0.5μg/kg，泵注持续时间为10min，术中静脉持续泵注盐酸右美托咪啶0.4μg/（kg·h）；B组缓慢注射0.9%氯化钠溶液10ml。监测患者麻醉自主呼吸恢复时、拔管前、拔管时和拔管后10min的心率（HR）、心率收缩压乘积（RPP）、平均动脉压（MAP），记录术后患者自主呼吸恢复时间、苏醒时间、拔管时间。结果两组患者在自主呼吸恢复时、拔管前血流动力学指标HR、MAP、RPP差异均无统计学意义（均P＞0.05），拔管时和拔管后10min上述指标差异有统计学意义（均P＜0.05），A组在拔管时和拔管后10min上述指标无明显变化（均P＞0.05），而B组拔管时和拔管后10min上述指标较拔管前有明显升高（P＜0.05），两组患者的自主呼吸恢复时间、苏醒时间和拔管时间基本一致，差异均无统计学意义（均P＞0.05）。结论盐酸右美托咪啶可保持全麻苏醒期的血流动力学稳定，对麻醉恢复期也无明显影响，有效预防妇科腹腔镜手术全麻患者苏醒期心血管反应的发生。
目的：探討鹽痠右美託咪啶對婦科腹腔鏡術中全痳患者心血管反應的預防作用。方法將擇期婦科腹腔鏡手術全痳患者70例，採用隨機數字錶法分為鹽痠右美託咪啶治療組（A組）和對照組（B組），各35例。A組于氣管插管誘導前10min靜脈泵註鹽痠右美託咪啶0.5μg/kg，泵註持續時間為10min，術中靜脈持續泵註鹽痠右美託咪啶0.4μg/（kg·h）；B組緩慢註射0.9%氯化鈉溶液10ml。鑑測患者痳醉自主呼吸恢複時、拔管前、拔管時和拔管後10min的心率（HR）、心率收縮壓乘積（RPP）、平均動脈壓（MAP），記錄術後患者自主呼吸恢複時間、囌醒時間、拔管時間。結果兩組患者在自主呼吸恢複時、拔管前血流動力學指標HR、MAP、RPP差異均無統計學意義（均P＞0.05），拔管時和拔管後10min上述指標差異有統計學意義（均P＜0.05），A組在拔管時和拔管後10min上述指標無明顯變化（均P＞0.05），而B組拔管時和拔管後10min上述指標較拔管前有明顯升高（P＜0.05），兩組患者的自主呼吸恢複時間、囌醒時間和拔管時間基本一緻，差異均無統計學意義（均P＞0.05）。結論鹽痠右美託咪啶可保持全痳囌醒期的血流動力學穩定，對痳醉恢複期也無明顯影響，有效預防婦科腹腔鏡手術全痳患者囌醒期心血管反應的髮生。
목적：탐토염산우미탁미정대부과복강경술중전마환자심혈관반응적예방작용。방법장택기부과복강경수술전마환자70례，채용수궤수자표법분위염산우미탁미정치료조（A조）화대조조（B조），각35례。A조우기관삽관유도전10min정맥빙주염산우미탁미정0.5μg/kg，빙주지속시간위10min，술중정맥지속빙주염산우미탁미정0.4μg/（kg·h）；B조완만주사0.9%록화납용액10ml。감측환자마취자주호흡회복시、발관전、발관시화발관후10min적심솔（HR）、심솔수축압승적（RPP）、평균동맥압（MAP），기록술후환자자주호흡회복시간、소성시간、발관시간。결과량조환자재자주호흡회복시、발관전혈류동역학지표HR、MAP、RPP차이균무통계학의의（균P＞0.05），발관시화발관후10min상술지표차이유통계학의의（균P＜0.05），A조재발관시화발관후10min상술지표무명현변화（균P＞0.05），이B조발관시화발관후10min상술지표교발관전유명현승고（P＜0.05），량조환자적자주호흡회복시간、소성시간화발관시간기본일치，차이균무통계학의의（균P＞0.05）。결론염산우미탁미정가보지전마소성기적혈류동역학은정，대마취회복기야무명현영향，유효예방부과복강경수술전마환자소성기심혈관반응적발생。
Objective To investigate the effect of dexmedetomidine hydrochloride on cardiovascular response in anes-thesia recovery period of laparoscopic gynecological surgery. Methods Seventy patients undergoing elective laparoscopic surgery under general anesthesia were divided into dexmedetomidine hydrochloride treatment group (group A, n=35) and con-trol group (group B, n=35). In group A 0.5μg/kg dexmedetomidine hydrochloride was infused intravenously 10 min before in-duction, then a dose of 0.4μg/ (kg·h) continuous intravenous infusion was given intraoperatively;group B was given slow in-jection of 0.9%sodium chloride solution 10ml instead. Heart rate (HR), rate pressure product (RPP) and mean arterial pressure (MAP) were monitored at restoration of spontaneous breathing, before extubation, extubation and 10min after extubation;the time of spontaneous breathing recovery, the anesthesia recovery time, extubation time were recorded. Results There were no dif-ferences in HR, MAP, RPP during spontaneous breathing restored between two groups (P>0.05), but differences at extubation and 10min after extubation (P<0.05). There were no significant changes in hemodynamic indexes between extubation and 10 min after extubation in group A (P>0.05), while there were significant differences in group B(P<0.05). There were no significant differences in spontaneous breathing recovery time, anesthesia recovery time and extubation time between two groups (P>0.05). Conclusion Dexmedetomidine hydrochloride can maintain stable hemodynamics at anesthesia recovery period and pre-vent cardiovascular reactions in laparoscopic gynecological surgery.
