中国医院用药评价与分析
中國醫院用藥評價與分析
중국의원용약평개여분석
Evaluation and Analysis of Drug-Use in Hospitals of China
2015年
11期
1442-1443,1444
,共3页
快速序贯诱导%右美托咪定%插管条件%血流动力学
快速序貫誘導%右美託咪定%插管條件%血流動力學
쾌속서관유도%우미탁미정%삽관조건%혈류동역학
Rapid-sequence induction%Dexmedetomidine%Intubation conditions%Hemodynamics
目的：探讨快速序贯诱导（rapid-sequence induction，RSI）前预注右美托咪定对插管条件及血流动力学的影响。方法：选择陕西省第二人民医院2013年4月—2014年4月收治的127例择期妇科手术行全身麻醉气管插管患者作为研究对象，按随机数字表法分为观察组和对照组。2组患者的麻醉操作与应用药物相同，观察组64例患者实施RSI前泵注右美托咪定0.6μg／kg，对照组63例患者泵注0.9％氯化钠注射液10 ml，比较2组患者喉镜暴露分级与RSI期间血氧分压（partial pressure of oxygen，PaO2）、动脉血二氧化碳分压（artial pressure of carbon dioxide in artery， PaCO2）变化情况。结果：观察组患者Cormach～LehaneⅠ级为60.94％（39／64），明显高于对照组的19.05％（12／63），差异有统计学意义（P＜0.05）；观察组患者给药结束即刻、插管完成即刻的PaCO2为（36.43±4.11）、（46.90±4.30） mmHg，均高于对照组的（32.50±2.52）、（40.73±3.81） mmHg，差异有统计学意义（P＜0.05）。结论：快速序贯诱导前预注右美托咪定可在不引起呼吸抑制情况下发挥镇静作用，降低插管难度，使插管期间血流动力学维持平稳，值得临床推广。
目的：探討快速序貫誘導（rapid-sequence induction，RSI）前預註右美託咪定對插管條件及血流動力學的影響。方法：選擇陝西省第二人民醫院2013年4月—2014年4月收治的127例擇期婦科手術行全身痳醉氣管插管患者作為研究對象，按隨機數字錶法分為觀察組和對照組。2組患者的痳醉操作與應用藥物相同，觀察組64例患者實施RSI前泵註右美託咪定0.6μg／kg，對照組63例患者泵註0.9％氯化鈉註射液10 ml，比較2組患者喉鏡暴露分級與RSI期間血氧分壓（partial pressure of oxygen，PaO2）、動脈血二氧化碳分壓（artial pressure of carbon dioxide in artery， PaCO2）變化情況。結果：觀察組患者Cormach～LehaneⅠ級為60.94％（39／64），明顯高于對照組的19.05％（12／63），差異有統計學意義（P＜0.05）；觀察組患者給藥結束即刻、插管完成即刻的PaCO2為（36.43±4.11）、（46.90±4.30） mmHg，均高于對照組的（32.50±2.52）、（40.73±3.81） mmHg，差異有統計學意義（P＜0.05）。結論：快速序貫誘導前預註右美託咪定可在不引起呼吸抑製情況下髮揮鎮靜作用，降低插管難度，使插管期間血流動力學維持平穩，值得臨床推廣。
목적：탐토쾌속서관유도（rapid-sequence induction，RSI）전예주우미탁미정대삽관조건급혈류동역학적영향。방법：선택합서성제이인민의원2013년4월—2014년4월수치적127례택기부과수술행전신마취기관삽관환자작위연구대상，안수궤수자표법분위관찰조화대조조。2조환자적마취조작여응용약물상동，관찰조64례환자실시RSI전빙주우미탁미정0.6μg／kg，대조조63례환자빙주0.9％록화납주사액10 ml，비교2조환자후경폭로분급여RSI기간혈양분압（partial pressure of oxygen，PaO2）、동맥혈이양화탄분압（artial pressure of carbon dioxide in artery， PaCO2）변화정황。결과：관찰조환자Cormach～LehaneⅠ급위60.94％（39／64），명현고우대조조적19.05％（12／63），차이유통계학의의（P＜0.05）；관찰조환자급약결속즉각、삽관완성즉각적PaCO2위（36.43±4.11）、（46.90±4.30） mmHg，균고우대조조적（32.50±2.52）、（40.73±3.81） mmHg，차이유통계학의의（P＜0.05）。결론：쾌속서관유도전예주우미탁미정가재불인기호흡억제정황하발휘진정작용，강저삽관난도，사삽관기간혈류동역학유지평은，치득림상추엄。
OBJECTIVE:To explore the effects of priming dexmedetomidine before rapid-sequence induction ( RIS) on intubating conditions and hemodynamics .METHODS:127 cases who underwent elective gynecologic operation for tracheal intubation under general anesthesia , admitted into the Second People's Hospital of Shaanxi from Apr .2013 to Apr.2014 were selected as the research objects;the patients were divided into observation group and control group via the random number table .The anesthesia procedure and drugs applied in the two groups were the same .0.6 μg/kg dexmedetomidine was injected before RSI to 43 cases from the observation group , while 42 cases in the control group received 10ml 0.9%sodium chloride injection .The laryngoscopic exposure grade and PaO 2 , PaCO2 during RSI were compared between the two groups .RESULTS:The proportion of Cormach ~Lehane I level in the observation group was [60.94%( 39/64 ) ] , which was significantly higher than that in the control group [ 19.05%( 12/63 ) ] , the difference was statistically significant ( P <0.05 ).The PaCO2 at the end of administration , immediately after intubation completion in observation group were higher than that in the control group [(36.43 ±4.11) mmHg,(46.90 ±4.30) mmHg VS(32.50 ±2.52) mmHg,(40.73 ±3.81) mmHg], the difference was statistically significant (P<0.05 ) .CONCLUSIONS:Priming dexmedetomidine before rapid-sequence induction can play a role of sedation without inducing respiratory inhibition , which can reduce intubation difficulty at the same time and maintain hemodynamics during intubation in stable state .It is worthy of clinical promotion .
