瑞芬太尼麻醉下脊柱侧弯矫形术中唤醒的临床疗效

发布时间：2018-01-06 12:12

本文关键词：瑞芬太尼麻醉下脊柱侧弯矫形术中唤醒的临床疗效　出处：《社区医学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探究瑞芬太尼麻醉下脊柱侧弯矫形术患者术中唤醒试验的临床疗效。方法选取2011年10月—2014年10月骨科收治的脊柱侧弯矫形术患者120例作为研究对象,随机分为对照组和观察组各60例。对照组在矫形术完成后直接送入监护室;观察组在矫形术固定装置安装完成后进行唤醒试验,检测指标测定完成后给予瑞芬太尼镇定,送入监护室。比较两组患者术后心率、血压以及术后清醒时间,对比术中知晓和术后谵妄的发生情况。计量资料采用t检验,计数资料采用χ2检验,P0.05为差异有统计学意义。结果观察组手术时间、麻醉时间、失血量、丙泊酚用量、瑞芬太尼用量、维库溴铵用量、血压、心率分别为(396±67)、(417±81)min、(2 011±438)ml、(83±14)、(156±22)、(36±8)mg、(61.5±4.3)mm Hg(1 mm Hg=0.133 k Pa)、(77.8±15.5)次/min,与对照组的(388±72)、(413±83)min、(1 988±457)ml、(86±14)、(149±26)、(38±5)mg、(62.5±4.6)mm Hg、(80.1±14.2)次/min比较差异均无统计学意义(均P0.05)。观察组睁眼时间、拔管时间和清醒时间分别为(4.7±1.4)、(7.7±2.1)、(9.3±2.4)min,与对照组的(4.4±1.3)、(7.8±2.3)、(9.1±2.6)min比较差异均无统计学意义(均P0.05)。观察组术中知晓率和术后谵妄发生率分别为3.33%、5.00%,与对照组的3.33%、5.00%比较差异均无统计学意义(均P0.05)。结论瑞芬太尼麻醉下脊柱侧弯矫形术术中唤醒对患者术后生命体征、情绪以及谵妄等无显著影响,手术效果良好,临床疗效显著,值得重视。
[Abstract]:Objective to investigate the clinical effect of intraoperative arousal test in patients with scoliosis under remifentanil anesthesia. Methods 120 patients with scoliosis were selected from October 2011 to October 2014. Example as the object of study. They were randomly divided into two groups: the control group (n = 60) and the observation group (n = 60). The patients in the observation group were given remifentanil after the installation of the orthopedic fixator was completed and remifentanil was given to the monitor unit. The heart rate blood pressure and postoperative waking time were compared between the two groups. Compare the incidence of intraoperative knowledge and postoperative delirium. T test was used to measure the data, and 蠂 2 test was used for counting data. Results the operation time and anesthesia time were significantly different in the observation group. The blood loss, propofol, remifentanil, vecuronium, blood pressure and heart rate were 47.6 卤81min, 2011 卤438ml, respectively. 83 卤14mm Hg(1 Hg=0.133 k Pa. 77.8 卤15.5times / min, compared with the control group (388 卤72mb, 413 卤83mmin, 1 988 卤457ml / min, 86 卤14). The results showed that there was no significant difference between the two groups (149 卤26) and 38 卤5 mg / g (62.5 卤4.6 mm Hg). There was no significant difference in 80.1 卤14.2times / min between the two groups (all P 0.05). The time of eye opening, extubation and waking were 4.7 卤1.4 in the observation group. Compared with the control group (4.4 卤1.3), the control group (7.7 卤2.1) was 9.3 卤2.4 min (7.8 卤2.3). There was no significant difference between the two groups at 9.1 卤2.6 min (all P 0.05). The rates of intraoperative awareness and postoperative delirium in the observation group were 3.33% and 5.00%, respectively. There was no significant difference between 3.33 and 5.00% of the control group (all P 0.05). Conclusion remifentanil anesthesia during scoliosis correction surgery for patients with postoperative vital signs. There is no significant effect on mood and delirium, the effect of operation is good, and the clinical effect is remarkable.
【作者单位】：德州市市立医院麻醉科;
【分类号】：R614
【正文快照】： 随着脊柱外科相关研究的不断深入,高技术含量手术逐渐增多,脊柱侧弯矫形术是一项涉及范围广、手术时间长、过程复杂并兼顾多种并发症的高难度手术[1]。脊柱侧弯矫形术可导致延迟性神经或血管损伤,低动脉压会造成脊髓缺血缺氧等,由于手术过程中不可免的内固定物对脊髓神经压迫

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