中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2015年
4期
3-4,5
,共3页
脊椎手术%控制性降压%靶控%瑞芬太尼%地氟醚
脊椎手術%控製性降壓%靶控%瑞芬太尼%地氟醚
척추수술%공제성강압%파공%서분태니%지불미
Spinal operation%Controlled hypotension%Target controlled%Remifentanil%Desflurane
目的：探讨靶控瑞芬太尼复合地氟醚在脊椎手术全身麻醉中控制性降压的临床效果。方法：选取2012年3月-2013年10月在笔者所在医院接受外伤致脊椎骨折经后入路切口开放复位内固定手术的患者36例，ASA分级Ⅰ~Ⅱ级，随机分为瑞芬太尼-地氟醚组(瑞芬太尼组)和芬太尼-丙泊酚组(对照组)，各18例。所有患者术前均无明显心、肺、肾、内分泌疾病和高血压病史。比较瑞芬太尼组和对照组麻醉前后平均动脉压、心率、血压恢复时间、拔管时间、睁眼时间及出血量。结果：瑞芬太尼组手术后10、30、60 min平均动脉压、心率均显著低于对照组(P<0.05)，停药后5 min平均动脉压高于对照组，心率亦高于对照组(P<0.05)；瑞芬太尼组血压恢复时间、拔管时间、睁眼时间及术中出血量均显著低于对照组(P<0.05)。结论：靶控输注瑞芬太尼复合地氟醚控制性降压应用于脊椎手术控制性降压效果理想。
目的：探討靶控瑞芬太尼複閤地氟醚在脊椎手術全身痳醉中控製性降壓的臨床效果。方法：選取2012年3月-2013年10月在筆者所在醫院接受外傷緻脊椎骨摺經後入路切口開放複位內固定手術的患者36例，ASA分級Ⅰ~Ⅱ級，隨機分為瑞芬太尼-地氟醚組(瑞芬太尼組)和芬太尼-丙泊酚組(對照組)，各18例。所有患者術前均無明顯心、肺、腎、內分泌疾病和高血壓病史。比較瑞芬太尼組和對照組痳醉前後平均動脈壓、心率、血壓恢複時間、拔管時間、睜眼時間及齣血量。結果：瑞芬太尼組手術後10、30、60 min平均動脈壓、心率均顯著低于對照組(P<0.05)，停藥後5 min平均動脈壓高于對照組，心率亦高于對照組(P<0.05)；瑞芬太尼組血壓恢複時間、拔管時間、睜眼時間及術中齣血量均顯著低于對照組(P<0.05)。結論：靶控輸註瑞芬太尼複閤地氟醚控製性降壓應用于脊椎手術控製性降壓效果理想。
목적：탐토파공서분태니복합지불미재척추수술전신마취중공제성강압적림상효과。방법：선취2012년3월-2013년10월재필자소재의원접수외상치척추골절경후입로절구개방복위내고정수술적환자36례，ASA분급Ⅰ~Ⅱ급，수궤분위서분태니-지불미조(서분태니조)화분태니-병박분조(대조조)，각18례。소유환자술전균무명현심、폐、신、내분비질병화고혈압병사。비교서분태니조화대조조마취전후평균동맥압、심솔、혈압회복시간、발관시간、정안시간급출혈량。결과：서분태니조수술후10、30、60 min평균동맥압、심솔균현저저우대조조(P<0.05)，정약후5 min평균동맥압고우대조조，심솔역고우대조조(P<0.05)；서분태니조혈압회복시간、발관시간、정안시간급술중출혈량균현저저우대조조(P<0.05)。결론：파공수주서분태니복합지불미공제성강압응용우척추수술공제성강압효과이상。
Objective:To investigate the clinical effect of target controlled(TCI) controlled hypotension with Remifentanil and Desflurane in spinal surgery of general anesthesia.Method:36 patients with spinal trauma fracture received posterior incision open reduction and internal fixation surgery were selected in our hospital from March 2012 to October 2013.ASA classification Ⅰ-Ⅱ,they were randomly divided into Remifentanil-Desflurane group(Remifentanil group) and Fentanyl-Propofol group(the control group),18 cases in each group.Preoperative patients had no obvious heart,lung, kidney,endocrine disease and hypertension.Remifentanil group and the control group before and after anesthesia of mean arterial pressure,heart rate,blood pressure,recovery time and extubation time,eye opening time and quantity of hemorrhage were compared.Result:Remifentanil group after operation in 10,30,60 minutes,mean arterial blood pressure and heart rate were significantly lower than those of the control group(P<0.05),5 minutes after discontinuation of mean arterial blood pressure was higher than that of the control group,the heart rate was higher than that of the control group(P<0.05).Remifentanil group blood pressure recovery time,pull the bleeding pipe time to eye opening,time and operation in volume were significantly lower than those of the control group(P<0.05).Conclusion:Target controlled infusion of Remifentanil with Desflurane controlled hypotension used in spinal surgery control has an ideal antihypertensive effect.
