摘要
目的探讨右美托咪定(Dexmedetomidine,DEX)对全麻行腹腔镜胆囊切除患者血流动力学的影响。方法方便选取该院肝胆外科2015年1—12月间接受并择期行腹腔镜胆囊切除的72例患者进行研究,麻醉方式均选择全身麻醉。按照随机数字表法将其等均分为两组,各36例,为其中一组患者在麻醉诱导前给予右美托咪定0.5μg/kg,纳入研究组;为另一组根据患者体重注射等容量的生理盐水。观察两组患者于全麻诱导前(T0)、诱导后(T1)、切皮后1min(T2)、苏醒时(T3)等不同时刻的血流动力学指标变化,并比较两组患者术中不良反应发生情况。结果研究组术中T1时,CI、SV、SVI、SVV分别为(2.7±0.5)、(71.3±12.2)、(43.6±9.3)、(9.1±3.0),T2时分别为(3.0±0.2)、(80.2±12.6)、(49.5±8.6)、(8.2±3.1)。T3时分别为(3.2±0.6)、(82.3±13.6)、(50.4±7.3)、(9.2±2.3),各项指标显著优于对照组,且研究各时段血流动力学指标变化幅度较小。差异有统计学意义(P<0.05);相比对照组,研究组术中不良反应较少仅有5.56%,用药安全性更高,差异有统计学意义(P<0.05)。结论为全麻行腹腔镜胆囊切除术患者选择右美托咪定进行麻醉,患者术中生命体征稳定,镇静镇痛效果较佳,起效迅速,且维持血流动力学稳定,值得推广应用。
Objective To study the effect of dexmedetomidine on the hemodynamics of patients with general anesthesia laparoscopic cholecystectomy. Methods 72 cases of patients with selective laparoscopic cholecystectomy admitted and treated in our hospital from January 2015 to December 2015 were convenient selected and randomly divided into two groups with36 cases in each, the research group adopted the dexmedetomidine of 0.5 μg/kg before anesthesia induction, and the control group were injected with the same amount of saline according to the weight of patients, and the changes of hemodynamics indexes were observed before the general anesthesia induction（T0）, after induction（T1）, at 1 min after skin incision（T2）and when waking up（T3）, and the occurrence of adverse reactions in operation was compared between the two groups. Results In the research group, at T1, the CI,SV,SVI,SVV were respectively（2.7±0.5）,（71.3±12.2）,（43.6±9.3）,（9.1±3.0）, at T2,（3.0±0.2）,（80.2±12.6）,（49.5±8.6）,（8.2±3.1）, at T3,（3.2±0.6）,（82.3±13.6）,（50.4±7.3）,（9.2±2.3）, and various indexes were obviously better than those in the control group, and the change range of hemodynamics indexes at various time phases was smaller, and the difference was statistically significant（P〈0.05）, and the intraoperative adverse reaction rate in the research group was only 5.56%, and the medication safety was higher, and the difference was statistically significant（P〈0.05）.Conclusion The dexmedetomidine anesthesia for patients with general anesthesia laparoscopic cholecystectomy can make the vital signs of patients steady and sedation and analgesia effect better and maintain the hemodynamics steady with rapid onset, which is worth promotion and application.
出处
《中外医疗》
2017年第17期153-155,共3页
China & Foreign Medical Treatment
关键词
右美托咪定
全麻
腹腔镜
胆囊切除
血流动力学
影响
Dexmedetomidine
General anesthesia
Laparoscopic
Cholecystectomy
Hemodynamics
Effect
