CAJ | 학술논문

目的：右美托咪定用于老年人髋关节置换术的效果观察。方法：随机选取2012年3月-2014年6月在本院行髋关节置换术的老年患者60例，并按入院的先后顺序分为A组、B组和C组，每组20例。A组患者静脉泵注4μg/mL右美托咪定10 min后，维持0.2μg/（kg·h）；B组静脉泵注4μg/mL右美托咪定10 min后，维持0.4μg/（kg·h）；C组静脉注射0.9%氯化钠溶液。观察并记录三组患者在麻醉前后、手术中和手术后的心率（HR）、平均动脉压（MAP）和血氧饱和度（SPO2）水平。记录三组患者的丙泊酚用量和清醒时间。同时，采用视觉模拟评分系统（VAS）对患者清醒时和手术后1 h的疼痛程度进行评分。观察患者手术后不良反应的发生率。结果：麻醉后，B组患者的SpO2水平显著低于A组和C组，差异有统计学意义（P<0.05）；B组患者的丙泊酚用量低于A组和C组（P<0.05）；A组患者的VAS评分低于B组和C组（P<0.05）；B组患者的低氧血症发生率高于A组和C组（P<0.05）。结论：右美托咪定用于老年人髋关节置换术，镇静效果显著，对呼吸抑制较轻，不良反应少。
목적：우미탁미정용우노년인관관절치환술적효과관찰。방법：수궤선취2012년3월-2014년6월재본원행관관절치환술적노년환자60례，병안입원적선후순서분위A조、B조화C조，매조20례。A조환자정맥빙주4μg/mL우미탁미정10 min후，유지0.2μg/（kg·h）；B조정맥빙주4μg/mL우미탁미정10 min후，유지0.4μg/（kg·h）；C조정맥주사0.9%록화납용액。관찰병기록삼조환자재마취전후、수술중화수술후적심솔（HR）、평균동맥압（MAP）화혈양포화도（SPO2）수평。기록삼조환자적병박분용량화청성시간。동시，채용시각모의평분계통（VAS）대환자청성시화수술후1 h적동통정도진행평분。관찰환자수술후불량반응적발생솔。결과：마취후，B조환자적SpO2수평현저저우A조화C조，차이유통계학의의（P<0.05）；B조환자적병박분용량저우A조화C조（P<0.05）；A조환자적VAS평분저우B조화C조（P<0.05）；B조환자적저양혈증발생솔고우A조화C조（P<0.05）。결론：우미탁미정용우노년인관관절치환술，진정효과현저，대호흡억제교경，불량반응소。
Objective:To observe the clinical effect of Dexmedetomidine for elderly patients undergoing total hip replacement.Method:60 elderly patients with total hip replacement were selected and randomly divided into 3 groups, 20 cases in each group.Patients in group A received a 4 μg/mL Dexmedetomidine intravenous infusion of 10 min, maintaining 0.2 g/(kg·h); patients in group B received a 4 μg/mL Dexmedetomidine intravenous infusion of 10 min, maintaining 0.4 g/(kg·h); patients in group C received a 0.9% Sodium Chloride Solution.The heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) level of 3 groups were observed and recorded before and after anesthesia, intraoperative and postoperative.The propofol dosage and awake time of 3 groups were recorded, respectively. At the same time, pain degree was measured by using visual analogue scoring system (VAS).The incidence of adverse reaction were observed after operation.Result:After anesthesia, the patients in the B group SPO2 was significantly lower than that of A group and C group, the difference was statistically significant (P<0.05).The patients in the B group of propofol dosage is lower than that of A group and C group (P<0.05).The patients in the A group VAS were lower than those of B group and C group (P<0.05).Hypoxemia in patients in the B group were higher than A group and C group(P<0.05).Conclusion:Dexmedetomidine for elderly total hip replacement, sedative effect significantly, the respiratory inhibition is lighter and less adverse reaction.