中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
4期
11-12,14
,共3页
右美托咪啶%单侧肺通气%吸入全麻%七氟烷%最低肺泡有效浓度(MAC)%术后躁动
右美託咪啶%單側肺通氣%吸入全痳%七氟烷%最低肺泡有效濃度(MAC)%術後躁動
우미탁미정%단측폐통기%흡입전마%칠불완%최저폐포유효농도(MAC)%술후조동
Dexmedetomidine%Unilateral lung ventilation%Inhalation anesthesia%Sevoflurane%Minimum alveolar concentra-tion(MAC)%Postoperative agitation
目的：探讨右美托咪啶对开胸手术单侧肺通气患者吸入七氟烷全麻MAC及术后躁动的影响。方法：2011年1月-2014年6月收治开胸手术患者60例，双盲法分为观察组和对照组，每组30例，观察组给予Dex 0.4μg/kg，于10 min以上泵注完，然后持续泵注Dex 0.4μg/(kg·h)；对照组给予等容量0.9%氯化钠溶液同时间内泵注，然后持续泵注等容量0.9%氯化钠溶液。术中吸入七氟醚+丙泊酚、舒芬太尼维持麻醉深度在Bis 45～55，观测两组维持七氟醚MAC 值、患者苏醒拔管时间及术后躁动发生情况。结果：在相同的丙泊酚、舒芬太尼泵注速度，相同的麻醉深度下，观察组维持吸入七氟醚MAC较对照组低，差异有统计学意义(t=3.29，P＜0.01)；观察组术后躁动发生率较对照组低，差异有统计学意义(χ2=4.32，P＜0.05)；两组苏醒时间比较差异无统计学意义(t=1.20，P＞0.05)。结论：Dex用于开胸手术单侧肺通气患者，能有效降低吸入七氟醚的MAC值，减少其用药量，降低患者术后躁动发生率。
目的：探討右美託咪啶對開胸手術單側肺通氣患者吸入七氟烷全痳MAC及術後躁動的影響。方法：2011年1月-2014年6月收治開胸手術患者60例，雙盲法分為觀察組和對照組，每組30例，觀察組給予Dex 0.4μg/kg，于10 min以上泵註完，然後持續泵註Dex 0.4μg/(kg·h)；對照組給予等容量0.9%氯化鈉溶液同時間內泵註，然後持續泵註等容量0.9%氯化鈉溶液。術中吸入七氟醚+丙泊酚、舒芬太尼維持痳醉深度在Bis 45～55，觀測兩組維持七氟醚MAC 值、患者囌醒拔管時間及術後躁動髮生情況。結果：在相同的丙泊酚、舒芬太尼泵註速度，相同的痳醉深度下，觀察組維持吸入七氟醚MAC較對照組低，差異有統計學意義(t=3.29，P＜0.01)；觀察組術後躁動髮生率較對照組低，差異有統計學意義(χ2=4.32，P＜0.05)；兩組囌醒時間比較差異無統計學意義(t=1.20，P＞0.05)。結論：Dex用于開胸手術單側肺通氣患者，能有效降低吸入七氟醚的MAC值，減少其用藥量，降低患者術後躁動髮生率。
목적：탐토우미탁미정대개흉수술단측폐통기환자흡입칠불완전마MAC급술후조동적영향。방법：2011년1월-2014년6월수치개흉수술환자60례，쌍맹법분위관찰조화대조조，매조30례，관찰조급여Dex 0.4μg/kg，우10 min이상빙주완，연후지속빙주Dex 0.4μg/(kg·h)；대조조급여등용량0.9%록화납용액동시간내빙주，연후지속빙주등용량0.9%록화납용액。술중흡입칠불미+병박분、서분태니유지마취심도재Bis 45～55，관측량조유지칠불미MAC 치、환자소성발관시간급술후조동발생정황。결과：재상동적병박분、서분태니빙주속도，상동적마취심도하，관찰조유지흡입칠불미MAC교대조조저，차이유통계학의의(t=3.29，P＜0.01)；관찰조술후조동발생솔교대조조저，차이유통계학의의(χ2=4.32，P＜0.05)；량조소성시간비교차이무통계학의의(t=1.20，P＞0.05)。결론：Dex용우개흉수술단측폐통기환자，능유효강저흡입칠불미적MAC치，감소기용약량，강저환자술후조동발생솔。
Objective:To explore the effects of dexmedetomidine on inhalation sevoflurane anesthesia MAC and postoperative agitation of patients with thoracotomy unilateral lung ventilation.Methods:60 patients with thoracotomy were selected from January 2011 to June 2014.They were divided into the observation group and the control group with 30 cases in each by double blind method.The observation group was given Dex 0.4 μg/kg,in more than 10 minutes pump injection,and then continuous infusion Dex 0.4 μg/(kg·h).The control group was given equal volume of 0.9% sodium chloride solution at the same time pumping,then continuous pump infusion equal volume of 0.9% sodium chloride solution.The anesthesia depth of intraoperative inhalation sevoflurane+propofol and sufentanil anesthesia was maintained at Bis 45~55.The maintain sevoflurane MAC value,revival and extubation time of patients and postoperative agitation of two groups were observed.Results:In the same propofol,sufentanil infusion speed,the same anesthesia depth,the maintain inhalation sevoflurane MAC value of the observation group was lower than that of the control group, and the difference was statistically significant(t=3.29,P<0.01).The incidence rate of postoperative agitation in the observation group was lower than that of the control group,and the difference was statistically significant(χ 2=4.32,P<0.05).The recovery time difference between two groups was not statistically significant(t=1.20,P>0.05).Conclusion:Using Dex for patients with thoracotomy unilateral lung ventilation can effectively reduce the inhalation sevoflurane MAC value, reduce the dosage,and reduce the incidence rate of postoperative agitation of patients.
