摘要
目的探讨右美托咪啶联合白眉蛇毒血凝酶用于鼻内镜手术中的效果。方法选取2016年11月至2018年6月在我院治疗的慢性鼻窦炎患者80例,将患者分为C组、D组、R组和DR组,每组20例,其中C组给予等量生理盐水,D组给予右美托咪啶,R组给予合白眉蛇毒血凝酶,DR组给予右美托咪啶联合白眉蛇毒血凝酶,观察各组患者麻醉前10 min(T0),气管插管即刻(T1),手术开始后5 min(T2)、15 min(T3)、45 min(T4)及拔管时(T5)的心率(HR)、平均动脉压(MAP)、收缩压(SBP)和舒张压(DBP)等。结果D组、R组和DR组T1时HR明显低于C组(P<0.05);D组、R组和DR组T2、T3、T4和T5时MAP、SBP和DBP明显高于C组(P<0.05);DR组手术时间、拔管时间和复苏时间分别为(60.19±10.01)min、(30.10±5.00)min和(20.04±6.82)min,明显短于C组、D组和R组(P<0.05);C组、D组、R组和DR组术前、术后PT、APTT和FIB比较差异无统计学意义(P>0.05);DR组术野质量评分为(2.65±0.81)分,明显低于C组、D组和R组(P<0.05);各组不良反应率差异比较无统计学意义。结论右美托咪啶联合白眉蛇毒血凝酶用于鼻内镜手术有较好的效果,值得临床使用。
Objective To investigate the effect of dexmedetomidine combined with hemocoagulase from Agkistrodon blomhoffii ussurensis(ABU)venom in nasal endoscopic surgery.Methods Included in this study were 80 patients with chronic sinusitis treated in our hospital between November 2016 and June 2018,assigned into group C,group D,group R and group DR(n=20 each).Group C was given a fixed amount of normal saline,group D was given dexmedetomidine,group R was given ABU venom hemocoagulase,and group DR was given dexmedetomidine plus ABU venom hemocoagulase.The heart rate(HR),mean arterial pressure(MAP),systolic blood pressure(SBP)and diastolic blood pressure(DBP)at 10 minutes before anesthesia(T0),immediately after tracheal intubation(T1),5 minutes(T2),15 minutes(T3),45 minutes(T4)of the operation,and extubation(T5),were recorded.Results At T1,the HRs in groups D,R and DR were significantly lower than that in group C(P<0.05);at T2,T3,T4 and T5,the MAP,SBP and DBP in groups D,R and DR were significantly higher than those in group C(P<0.05).The operation time,extubation time and resuscitation time in DR group were(60.19±10.01)min,(30.10±5.00)min and(20.04±6.82)min,which were significantly shorter than those in groups C,D and R(P<0.05).There were no significant differences in PT,APTT and FIB among groups C,D,R and DR before and after operation(P>0.05).The surgical field quality score in group DR was(2.65±0.81),which was significantly lower than those in groups C,D and R(P<0.05).There was no significant difference in incidence of adverse reactions among groups.Conclusion Dexmedetomidine combined with hemocoagulase from Agkistrodon blomhoffii ussurensis venom offers good efficacy in endoscopic sinus surgery and is worthy of clinical use.
作者
申震
李白牙
邵渊
张鹏飞
Shen Zhen;Li Baiya;Shao Yuan;Zhang Pengfei(Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of Xi'an Jiaotong University,Xi’an 710000)
出处
《中华生物医学工程杂志》
CAS
2019年第5期547-551,共5页
Chinese Journal of Biomedical Engineering
关键词
右美托咪啶
白眉蛇毒血凝酶
鼻内镜手术
临床效果
Dexmedetomidine
Agkistrodon blomhoffii ussurensis venom hemocoagulase
Endoscopic sinus surgery
Clinical efficacy
