CAJ | 학술논문

目的：比较右美托咪定、地佐辛及其二者联合对全身麻醉患者苏醒期躁动及血流动力学的影响，为临床合理用药提供依据。方法：选择符合标准的患者90例，随机分为A组、B组及C组各30例，A组应用右美托咪定、B组应用地佐辛、C组应用右美托咪定及地佐辛，观察并记录三组患者麻醉前（ T0）、气管拔管后5min（ T1）及气管拔管后10min（ T2）时间点的收缩压（ SBP ）、舒张压（ DBP ）和心率（ HR），同时观察苏醒期躁动发生情况。结果：三组患者在手术时间、术中出血量、术中输入液体量等相似，差异无统计学意义（ P＞0．05）。三组患者T0时间点SBP、DBP 及HR相似，差异无统计学差异（P＞0．05）。 A组及B组患者T1、T2时间点SBP、DBP 及HR相似，差异无统计学差异（P＞0．05）。 C组患者T1、T2时间点SBP、DBP及HR较A组及B组更稳定，差异具有统计学意义（ P＜0．05）。三组患者苏醒期均未发生中度躁动、过度镇静和苏醒延迟，发生轻度躁动A组9例、B组10例和C组2例，A组和B组比较，差异无统计学差异（ P＞0．05）；C组躁动发生率明显低于A组和B组，差异具有统计学意义（ P＜0．05）。结论：右美托咪定联合地佐辛能更有效的稳定全身麻醉患者苏醒期的血压及心率，降低躁动发生几率，值得临床推广应用。
목적：비교우미탁미정、지좌신급기이자연합대전신마취환자소성기조동급혈류동역학적영향，위림상합리용약제공의거。방법：선택부합표준적환자90례，수궤분위A조、B조급C조각30례，A조응용우미탁미정、B조응용지좌신、C조응용우미탁미정급지좌신，관찰병기록삼조환자마취전（ T0）、기관발관후5min（ T1）급기관발관후10min（ T2）시간점적수축압（ SBP ）、서장압（ DBP ）화심솔（ HR），동시관찰소성기조동발생정황。결과：삼조환자재수술시간、술중출혈량、술중수입액체량등상사，차이무통계학의의（ P＞0．05）。삼조환자T0시간점SBP、DBP 급HR상사，차이무통계학차이（P＞0．05）。 A조급B조환자T1、T2시간점SBP、DBP 급HR상사，차이무통계학차이（P＞0．05）。 C조환자T1、T2시간점SBP、DBP급HR교A조급B조경은정，차이구유통계학의의（ P＜0．05）。삼조환자소성기균미발생중도조동、과도진정화소성연지，발생경도조동A조9례、B조10례화C조2례，A조화B조비교，차이무통계학차이（ P＞0．05）；C조조동발생솔명현저우A조화B조，차이구유통계학의의（ P＜0．05）。결론：우미탁미정연합지좌신능경유효적은정전신마취환자소성기적혈압급심솔，강저조동발생궤솔，치득림상추엄응용。
Objective: To compare the effect of dexmedetomidine , dezocine and coadministration of them on the hemodynamics and restlessness in the stage of analepsia in patients under general anesthesia , and to provide foundations for clinical rational administration .Method:Ninety eligible patients were selected and randomly divided into group A , group B and group C , with 30 patients in each group; group A used dexmedetomidine , group B used dezocine , and group C used dexmedetomidine and dezocine; the systolic blood pressures (SBP), diastolic blood pressures (DBP) and heart rates (HR) before anesthesia (T0), 5min after tracheal extubation ( T1 ) and at 10min after tracheal extubation ( T2 ) and the restlessness in the stage of analepsia in the patients of the three groups were observed and recorded .Result:The patients of the three groups had similar operative time , intra-operative blood loss , and intra-operative volume of fluid in-fused, and the differences were statistically insignificant ( P>0.05).The patients of the three groups had similar SBP , DBP and HR at T0, and the differences were statistically insignificant ( P>0.05) .The patients of the group A and the group B had similar SBP , DBP and HR at T1 and T2, and the differences were statis-tically insignificant (P>0.05).The patients of the group C had more stable SBP , DBP and HR at T1 and T2 than the patients of the group A and the group B , and the differences were statistically significant ( P<0.05) . No moderate restlessness , excessive sedation or palinesthesia delay occurred in the patients of the three groups in the stage of analepsia .But mild restlessness occurred in 9 patients of the group A , 10 patients of the group B and 2 patients of the group C , the difference between the group A and the group B was statisti-cally insignificant ( P>0.05) , and the restlessness incidence in the patients of the group C was significantly lower than that of the group B and the group C ( P<0.05) .Conclusion:Coadministration of dexmedetomidine and dezocine can stabilize the blood pressure and heart rate in the stage of analepsia more effectively , and decrease the incidence of restlessness in patients under general anesthesia , and consequently is worthy of clinical application .