摘要
目的评价右美托咪啶对口腔颌面肿瘤根治术患者经鼻清醒插管应激反应的影响。方法选取择期行口腔颌面肿瘤根治术患者40例,ASAⅠ或Ⅱ级,年龄20~62岁,性别不限,体质指数<25。按随机数字表法分为两组(n=20):右美托咪啶组(D组)和咪达唑仑组(M组)。记录平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2)变化,记录呼吸抑制发生率、患者对插管过程的耐受程度、患者的配合程度和术后对插管过程的不良记忆情况。结果两组T1的HR比T0时较均升高,差异具有统计学意义(P<0.05)。M组T1-2时的MAP和HR及T3时HR比T0时升高,差异具有统计学意义(P<0.05)。与M组比较,D组T1-2时的MAP和HR,T3时HR降低,差异具有统计学意义(P<0.05)。D组呼吸抑制发生率较M组降低,气管插管舒适度和配合程度评分较M组降低(P<0.05)。结论右美托咪啶可以减轻口腔颌面肿瘤根治术患者经鼻清醒气管插管的应激反应,提高患者舒适度,减少呼吸抑制发生率,维持血流动力学稳定,保证了插管的安全性。
Objective To evaluate the Effect of dexmedetomidine on the stress reaction for awake nasotracheal intubation in patients with maxillofacial tumor. Methods Forty patients, which are ASA physical status Ⅰ or Ⅱ , aged 20 ~ 62 yr, BMI 〈 25 and scheduled for radical operation for maxillofaeial tuomr, were randomly divided into 2 groups （n = 20 each ） using a random number table ： dexmedetomidine groups （group D ） and midazolam group （group M ）. MAP, HR, SpO2 were recorded, and the rate of respiratory depression, the degree of tolerance and matching and the memory to intubation were recorded. Results Compared with the baseline value at TO, MAP and HR at T1-2 and HR at T3 were increased in group M. HR were increased at T1 in group D（P 〈 0.05）. Compared with group M, MAP and HR at T1-2 and HR at T3 were decresed in group D （P 〈 0.05 ）. The rate of respiratory depression in group D was decreased compared with group M, and the degree of tolerance and matching to intubation was better in group D. Conclusion dexmedetomidine can inhibit the stress reaction caused by nasotracheal intubation in patients with maxillofacial tuomr, and improve the degree of comfort and security in the process of intubation.
出处
《实用医学杂志》
CAS
北大核心
2017年第17期2915-2917,共3页
The Journal of Practical Medicine
关键词
右美托咪啶
清醒镇静
插管法
气管内
口腔肿瘤
dexmedetomidine
conscious sedation
intubation
intratracheal
mouth neoplasms
