CAJ | 학술논문

目的：探讨盐酸右美托咪定用于立体定向颅内血肿微创抽吸术治疗脑出血的麻醉效果。方法：高血压脑出血患者69例，随机分为观察组34例及对照组35例。2组术前麻醉时均先静脉注射芬太尼1μg/kg，对照组采用常规麻醉方法，观察组采用盐酸右美托咪定进行麻醉，记录患者进入手术室（T1）、应用丙泊酚或盐酸右美托咪定后（T2）、安置头架后（T3）、钻孔时（T4）时的平均动脉压（MAP）、氧分压（PaO2）、二氧化碳分压（PaCO2），并比较2组出现的不良反应。结果：与对照组比较，观察组心率在T3、T4时间明显降低，PaO2明显升高，差异有统计学意义（<0.05），MAP、PaCO2在T4时间差异有统计学意义（<0.05）。观察组术中低血压、心动过速、躁动及术后呕吐发生人数低于对照组，差异有统计学意义（<0.05）。结论：盐酸右美托咪定用于立体定向颅内血肿微创抽吸术治疗脑出血的麻醉效果较丙泊酚好良好，心率、MAP、PaO2波动小，呼吸抑制较少。
목적：탐토염산우미탁미정용우입체정향로내혈종미창추흡술치료뇌출혈적마취효과。방법：고혈압뇌출혈환자69례，수궤분위관찰조34례급대조조35례。2조술전마취시균선정맥주사분태니1μg/kg，대조조채용상규마취방법，관찰조채용염산우미탁미정진행마취，기록환자진입수술실（T1）、응용병박분혹염산우미탁미정후（T2）、안치두가후（T3）、찬공시（T4）시적평균동맥압（MAP）、양분압（PaO2）、이양화탄분압（PaCO2），병비교2조출현적불량반응。결과：여대조조비교，관찰조심솔재T3、T4시간명현강저，PaO2명현승고，차이유통계학의의（<0.05），MAP、PaCO2재T4시간차이유통계학의의（<0.05）。관찰조술중저혈압、심동과속、조동급술후구토발생인수저우대조조，차이유통계학의의（<0.05）。결론：염산우미탁미정용우입체정향로내혈종미창추흡술치료뇌출혈적마취효과교병박분호량호，심솔、MAP、PaO2파동소，호흡억제교소。
Objective:To investigate the effect of dexmedetomidine anaesthesia on stereoscopic hematoma aspira-tion in treating cerebral hemorrhage. Methods: Sixty-nine patients with hypertensive cerebral hemorrhage were randomly divided into the observation group of 34 cases and the control group with 35 cases. All the patients were initially injected with 1 μg/kg of Fentanyl before preoperative anesthesia. The control group was treated with rou-tine anesthesia methods. The observation group was anaesthetized with dexmedetomidine. The mean arterial blood pressure (MAP), PaO2, PaCO2 in the patients in operating room (T1), propofol and dexmedetomidine (T2), after placement of head frame (T3), after drilling (T4), were recorded. The adverse reactions of the two groups were com-pared. Results:In the observation group, the heart rate in the T 3 and T4 time group was significantly decreased com-pared with the control group whereas the PaO2 in the T3 and T4 time group was significantly increased compared with the control group ( <0.05). Compared with the control group, the MAP, PaCO 2 in T4 time of the observation group showed significant changes ( <0.05). The hypotension, tachycardia, impetuous people, postoperative vomit-ing numbers in the observation group changed significantly compared with the control group( <0.05). Conclusion:Compared with propofol, dexmedetomidine showed a better effect on anesthesia for the treatment of cerebral hem-orrhageusing stereotactically minimal invasive suction of intracranial hematomas. The patients showed more stable MAP, heart rate, PaO2 wave, and less respiratory depression.