中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
3期
353-355
,共3页
陈宏尊%胡雨林%黄海%郇心乐
陳宏尊%鬍雨林%黃海%郇心樂
진굉존%호우림%황해%순심악
右旋美托咪啶%脑肿瘤%外科手术%芬太尼%血液动力学现象
右鏇美託咪啶%腦腫瘤%外科手術%芬太尼%血液動力學現象
우선미탁미정%뇌종류%외과수술%분태니%혈액동역학현상
Dexmedetomidine%Brain neoplasms%Surgical procedures%Fentanyl%Hemodynamic phenomena
目的 探讨脑肿瘤患者术中应用右旋美托咪啶对芬太尼剂量及血流动力学的影响及其安全性.方法 选择欲行脑肿瘤切除术的患者共62例,随机分为观察组和对照组各31例,观察组应用右旋美托咪啶0.5 μg/kg,30 min后1.0 μg·kg-1·h-1泵注.对照组予0.9％氯化钠注射液以同样的方式同步输注.记录并比较两组患者在术中所用的麻醉药的剂量以及血流动力学的改变.结果 观察组患者在进行麻醉诱导以及其后的整个手术过程中的平均心率和平均动脉压均低于基础值(均P ＜0.05),对照组患者在手术进行60 min后其平均心率和平均动脉压始低于基础值(均P＜0.05),观察组全程的平均心率和平均动脉压均低于对照组(均P＜0.05).观察组应用芬太尼的剂量低于对照组[分别为(427.5±61.2)、(704.3±84.1) μg](t=95.721,P＜0.05),异氟烷的呼气末浓度也低于对照组(P＜0.05).结论 右旋美托咪啶应用于脑肿瘤术中稳定脑血流动力学的效果确切,安全性好,可显著减少术中所需的麻醉药及麻醉辅助剂的剂量.
目的 探討腦腫瘤患者術中應用右鏇美託咪啶對芬太尼劑量及血流動力學的影響及其安全性.方法 選擇欲行腦腫瘤切除術的患者共62例,隨機分為觀察組和對照組各31例,觀察組應用右鏇美託咪啶0.5 μg/kg,30 min後1.0 μg·kg-1·h-1泵註.對照組予0.9％氯化鈉註射液以同樣的方式同步輸註.記錄併比較兩組患者在術中所用的痳醉藥的劑量以及血流動力學的改變.結果 觀察組患者在進行痳醉誘導以及其後的整箇手術過程中的平均心率和平均動脈壓均低于基礎值(均P ＜0.05),對照組患者在手術進行60 min後其平均心率和平均動脈壓始低于基礎值(均P＜0.05),觀察組全程的平均心率和平均動脈壓均低于對照組(均P＜0.05).觀察組應用芬太尼的劑量低于對照組[分彆為(427.5±61.2)、(704.3±84.1) μg](t=95.721,P＜0.05),異氟烷的呼氣末濃度也低于對照組(P＜0.05).結論 右鏇美託咪啶應用于腦腫瘤術中穩定腦血流動力學的效果確切,安全性好,可顯著減少術中所需的痳醉藥及痳醉輔助劑的劑量.
목적 탐토뇌종류환자술중응용우선미탁미정대분태니제량급혈류동역학적영향급기안전성.방법 선택욕행뇌종류절제술적환자공62례,수궤분위관찰조화대조조각31례,관찰조응용우선미탁미정0.5 μg/kg,30 min후1.0 μg·kg-1·h-1빙주.대조조여0.9％록화납주사액이동양적방식동보수주.기록병비교량조환자재술중소용적마취약적제량이급혈류동역학적개변.결과 관찰조환자재진행마취유도이급기후적정개수술과정중적평균심솔화평균동맥압균저우기출치(균P ＜0.05),대조조환자재수술진행60 min후기평균심솔화평균동맥압시저우기출치(균P＜0.05),관찰조전정적평균심솔화평균동맥압균저우대조조(균P＜0.05).관찰조응용분태니적제량저우대조조[분별위(427.5±61.2)、(704.3±84.1) μg](t=95.721,P＜0.05),이불완적호기말농도야저우대조조(P＜0.05).결론 우선미탁미정응용우뇌종류술중은정뇌혈류동역학적효과학절,안전성호,가현저감소술중소수적마취약급마취보조제적제량.
Objective To study the effect and safety of dexmedetomidine on the intraoperative fentanyl requirements and cerebral hemodynamics in patients undergoing intracranial tumor surgery.Methods 62 patients scheduled for intracranial tumor surgery were selected and divided into observe group (31 cases) and control group(31 cases).Dexmedetomidine (0.5 μg/kg) was loaded in observe group,and followed by a continuous infusion of a rate of 1.0pμg · kg-1 · h-1 half an hour later.Saline was infused in the same time and the same way in control group.Dose of anesthetic and change of cerebral hemodynamics were recorded and compared.Results The mean heart rate and mean arterial blood pressure were lower in observe group than the underlying value when inducing anesthesia and during the operation (all P ＜ 0.05),while that happened after operation starting 60 minutes later in control group(all P ＜0.05).The mean heart rate and mean arterial blood pressure were lower in observe group those that in control group (all P ＜ 0.05).Dose of fentanyl and end-tidal sevoflurane concentration were lower in observe group(all P ＜ 0.05).Conclusion Dexmedetomidine used for cerebral hemodynamics stabiliby in intracranial tumor surgery has obvious curative effect and good safety.And it could decrease the dose of anesthetics and anesthesia adjuvant.
