利多卡因胶浆对高血压患者脑动脉瘤栓塞术拔管期应激反应的影响

发布时间：2018-01-29 02:10

本文关键词： 利多卡因胶浆脑动脉瘤栓塞术高血压患者应激反应　出处：《广东医学》2015年20期 　论文类型：期刊论文

【摘要】：目的探讨利多卡因胶浆预防高血压脑动脉瘤栓塞术患者拔管反应的效果。方法将36例择期行脑动脉瘤栓塞术合并高血压的患者分为A、B两组,每组18例。B组的气管导管前端使用盐酸利多卡因胶浆5m L均匀涂抹至超过套囊后5 cm处,A组使用0.9%氯化钠注射液5 m L涂抹。观察两组患者麻醉前(T0),拔除气管导管前(T1),拔除气管导管后2 min(T2)、5 min(T3)和10 min(T4)的血氧饱和度(SpO2)、心率(HR)、收缩压(SBP)及舒张压(DBP),同时检测血浆肾上腺素和去甲肾上腺素的浓度,并观察拔管期的不良反应发生情况。结果两组患者在T0和T4时SpO2、HR、SBP及DBP的差异无统计学意义(P0.05);T1、T2、T3时A组患者HR、SBP及DBP高于B组,差异有统计学意义(P0.05)。A组不良反应发生率明显高于B组(P0.05)。结论利多卡因胶浆应用于脑动脉瘤栓塞术的高血压患者可以有效降低气管导管拔除期的应激反应,并减少不良反应的发生,可供临床选择应用。
[Abstract]:Objective to investigate the effect of lidocaine glue on the prevention of extubation reaction in patients with hypertensive cerebral aneurysm embolization. Methods 36 patients undergoing selective cerebral aneurysm embolization combined with hypertension were divided into two groups. The anterior end of tracheal duct in group B was smeared with Lidocaine hydrochloride (Lidocaine) at the front end of trachea tube in each group (n = 18). Group A was smeared with 0.9% sodium chloride injection (5ml). The patients in both groups were treated with T0 before anesthesia, T1 before tracheal catheter was removed and T2 was removed 2 mins after trachea catheter was removed. SPO _ 2, HR, SBP and DBP) of 5 min T3 and 10 min T4). The plasma levels of epinephrine and norepinephrine were measured simultaneously, and the adverse reactions during extubation were observed. The difference between SBP and DBP was not statistically significant (P 0.05). HRP and DBP in group A were higher than those in group B at T _ 2 T _ 3. The incidence of adverse reactions in group A was significantly higher than that in group B (P 0.05). Conclusion Lidocaine glue can effectively reduce the stress response during tracheal extubation in hypertensive patients undergoing cerebral aneurysm embolization. And to reduce the occurrence of adverse reactions, for clinical application.
【作者单位】：暨南大学第二临床医学院广东省深圳市人民医院麻醉科;暨南大学第二临床医学院广东省深圳市人民医院老年病科;
【基金】：广东省深圳市科技创新委员会资助项目(编号:JCYJ20140416122812031)
【分类号】：R651.1
【正文快照】： 麻醉恢复期由于麻醉药物作用逐渐消除,气管导管对气管黏膜的强烈刺激常常诱发患者剧烈呛咳和躁动,从而引起血流动力学的剧烈波动和颅内压升高等。对普通患者影响有限,但对于脑动脉瘤栓塞术的患者则另当别论,因为强烈的应激反应会显著升高患者的颅内压,加重患者的脑血管痉挛甚

【参考文献】