右美托咪定对Wilson病继发脾功能亢进患者全身麻醉下脾切除术后躁动的影响

发布时间：2018-06-06 19:29

本文选题：右美托咪定 + 术后躁动　；参考：《中国药房》2017年32期

【摘要】：目的:观察右美托咪定对Wilson病继发脾功能亢进患者全身麻醉下脾切除术后躁动的影响。方法:选取某院2016年1-12月的全身麻醉下行脾切除术Wilson病继发脾功能亢进患者60例,按随机数字表法分为对照组和观察组,各30例。观察组患者麻醉诱导前15 min静脉恒速泵注右美托咪定0.4μg/kg,之后为0.4μg/(kg·h)维持至脾切除后;对照组患者给予等量的生理盐水,其余麻醉方案两组相同。观察两组患者开始泵注前(T_0)、插管前(T_1)、插管后1 min(T_2)、拔管前(T_3)及拔管后3 min(T_4)的平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO_2),记录两组患者T_3和T_4时间点Riker镇静-躁动评分(SAS),比较两组患者麻醉后监测治疗室(PACU)停留时间及心动过缓发生情况。结果:T_0时,两组患者MAP、HR、SpO_2水平比较,差异无统计学意义(P0.05);T1、T_2、T_3、T_4时,两组患者MAP、HR水平均显著降低,且观察组显著低于对照组,差异均有统计学意义(P0.05);但SpO_2所有时间点均为100%,组间比较,差异无统计学意义(P0.05)。观察组患者T_3、T_4时Riker SAS评分均显著低于对照组,差异均有统计学意义(P0.05)。观察组患者心动过缓发生率为26.67%,显著高于对照组的3.33%,差异有统计学意义(P0.05),但静脉注射阿托品后均得以纠正。观察组PACU停留时间显著短于对照组,差异有统计学意义(P0.05)。结论:右美托咪定能稳定Wilson病继发脾功能亢进患者术后血流动力学,降低躁动情况,并缩短PACU转出时间。
[Abstract]:Objective: To observe the effect of dexmedetomidin on the agitation after splenectomy under general anaesthesia for patients with secondary hypersplenism secondary to Wilson's disease. Methods: 60 patients with hypersplenism secondary to splenectomy and splenectomy in 1-12 months of 2016 were selected and divided into the control group and the observation group, 30 cases in the observation group. The 15 min intravenous constant speed pump before inducement was 0.4 mu of right metomomidine, followed by 0.4 mu g/ (kg. H) after splenectomy; the control group was given equal amount of saline, and the rest of the two groups were the same. The two groups were observed before the pump (T_0), before intubation (T_1), 1 min (T_2) after intubation, and the average of 3 min (T_4) after extubation (T_3) and extubation Arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO_2) were recorded in two groups of patients with T_3 and T_4 time Riker sedation restlessness score (SAS). The retention time and bradycardia of therapeutic room (PACU) after anesthesia were compared in the two groups. Results: T_0, there was no statistical difference between the two groups of MAP, HR, and SpO_2 levels. At T_4, the level of MAP and HR decreased significantly in the two groups, and the observation group was significantly lower than the control group (P0.05), but all the time points of SpO_2 were 100%, and the difference between the groups was not statistically significant (P0.05). The Riker SAS scores of the patients in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P0.05). The incidence of bradycardia in the patients in the group was 26.67%, which was significantly higher than that of the control group (3.33%). The difference was statistically significant (P0.05), but all of them were corrected after intravenous atropine. The PACU stay time in the observation group was significantly shorter than that of the control group (P0.05). Conclusion: dexmedetomidin could stabilize the patients with Wilson disease secondary to hypersplenism. After hemodynamics, reduce restlessness and shorten the turn out time of PACU.
【作者单位】：安徽医科大学第二附属医院麻醉科;安徽中医药大学第一附属医院麻醉科;
【基金】：国家自然科学基金资助项目(No.81471145)
【分类号】：R614

【相似文献】