CAJ | 학술논문

目的：探讨盐酸右美托咪定复合靶控输注丙泊酚在肝癌射频消融术中应用的有效性及安全性。方法选择射频消融治疗肝癌患者60例，ASAⅠ～Ⅱ级，随机分为3组，每组20例：Ⅰ组（盐酸右美托咪定组）、Ⅱ组（靶控输注丙泊酚组）、Ⅲ组（盐酸右美托咪定+靶控输注丙泊酚组）。记录治疗开始前、治疗开始后5 min、结束即刻、出室时患者的心率（HR）、平均动脉压（MAP）、呼吸频率（RR）、脉搏血氧饱和度（SpO2），同时记录苏醒时间、不良反应发生率、医生满意度评分。结果Ⅱ组治疗开始后5 min MAP[（69±8）mmHg]、HR[（69±3）次/min]、RR[（16±5）次/min]、SpO2[（90±4）%]与治疗前相比均明显降低（P<0.05）。Ⅲ组的苏醒时间显著短于Ⅱ组[（1.1±0.1）min vs.（3.1±0.2）min，P<0.05]，Ⅲ组的医生满意度评分明显高于Ⅰ组与Ⅱ组（3.8±0.3 vs.1.9±0.3、2.0±0.6，P<0.05）。Ⅲ组呼吸暂停的发生率（0%）及低血压的发生率（5%）也明显低于Ⅱ组（20%、35%，P<0.05）。结论盐酸右美托咪定复合靶控输注丙泊酚用于超声引导下射频消融治疗肝癌安全可靠，患者术中循环呼吸平稳，苏醒快，医生满意度高。
목적：탐토염산우미탁미정복합파공수주병박분재간암사빈소융술중응용적유효성급안전성。방법선택사빈소융치료간암환자60례，ASAⅠ～Ⅱ급，수궤분위3조，매조20례：Ⅰ조（염산우미탁미정조）、Ⅱ조（파공수주병박분조）、Ⅲ조（염산우미탁미정+파공수주병박분조）。기록치료개시전、치료개시후5 min、결속즉각、출실시환자적심솔（HR）、평균동맥압（MAP）、호흡빈솔（RR）、맥박혈양포화도（SpO2），동시기록소성시간、불량반응발생솔、의생만의도평분。결과Ⅱ조치료개시후5 min MAP[（69±8）mmHg]、HR[（69±3）차/min]、RR[（16±5）차/min]、SpO2[（90±4）%]여치료전상비균명현강저（P<0.05）。Ⅲ조적소성시간현저단우Ⅱ조[（1.1±0.1）min vs.（3.1±0.2）min，P<0.05]，Ⅲ조적의생만의도평분명현고우Ⅰ조여Ⅱ조（3.8±0.3 vs.1.9±0.3、2.0±0.6，P<0.05）。Ⅲ조호흡잠정적발생솔（0%）급저혈압적발생솔（5%）야명현저우Ⅱ조（20%、35%，P<0.05）。결론염산우미탁미정복합파공수주병박분용우초성인도하사빈소융치료간암안전가고，환자술중순배호흡평은，소성쾌，의생만의도고。
Objective To compare the effectiveness and safety of dexmedetomidine (DEX) vs. target control Infu-sion (TCI) of propofol alone vs. DEX plus TCI propofol for radiofrequency ablation (RFA) of liver cancer. Methods Sixty patients scheduled for RFA were randomly allocated into three groups (n=20, each). DEX group (Ⅰ) and TCI propofol group (Ⅱ) and DEX plus TCI propofol group (Ⅲ). Outcome parameters were the procedure duration, the adverse-effect rates and the satisfaction of operators about the quality of aneathesia. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and respiration rate (RR) were also monitored and recorded at the following time points:baseline, 5 min after start of procedure, the end of procedure, time of discharge. Results The MAP [(69 ±8)mmHg]、HR [(69±3)bpm], RR[(16±5)] and SpO2(90±4)%] changed significantly 5 min after start of the procedure compared with baseline (P<0.05). The recovery time in group Ⅲ [(1.1±0.1)min] was shorter than that in groups Ⅱ [(3.1±0.2)min, P< 0.05]. The satisfaction score about the quality of aneasthesia from doctors was significantly higher in group Ⅲ (3.8±0.3) than that in groupⅡ (2.0±0.6)and groupⅠ (1.9±0.3, P<0.05). Moreover, rates of apnea (0%) and hypotension (5%) were lower in group Ⅲ than that in group Ⅱ (20% and 35%, P< 0.05). Conclusion DEX combined with TCI propofol allows stable hemodynamic status, fast recovery as well as high satisfaction. It provides effective and safe sedation for RFA.