右美托咪定对不同类型垂体肿瘤切除术患者血流动力学的影响

发布时间：2018-06-09 12:19

本文选题：右美托咪定 + 垂体肿瘤　；参考：《临床麻醉学杂志》2015年09期

【摘要】：目的观察右美托咪定对不同类型垂体肿瘤切除术患者血流动力学的影响。方法回顾分析北京协和医院2013年8月至11月接受经鼻-蝶窦垂体肿瘤切除术的患者60例,分为右美托咪定组(D组)24例,对照组(C组)36例,右美托咪定组患者麻醉诱导后静脉持续泵注右美托咪定0.5μg·kg-1·h-1,直至手术结束;对照组接受常规全身麻醉。进一步分析右美托咪定对垂体无功能腺瘤切除术患者血流动力学的影响。记录麻醉前(术前)、切除垂体腺瘤期间(术中)及在麻醉恢复室苏醒期(术后)的SBP、DBP和HR的最高值(max)与最低值(min);术前、术后WBC、Hb、Plt的变化;术前与术后体温,术中芬太尼用量、手术时间、苏醒时间、住院天数等。结果与C组比较,D组患者术中SBPmax,术后SBPmax、SBPmin均明显降低,HRmax明显减慢(P0.05);垂体无功能腺瘤患者术中SBPmax,术后苏醒期SBPmax、SBPmin、DBPmax、DBPmin明显降低,HRmax明显减慢(P0.05)。术中应用右美托咪定对生长激素腺瘤或库欣病腺瘤患者术中及术后血流动力学指标无明显影响。两组患者术中芬太尼用量、手术时间、苏醒时间、住院天数以及术前术后体温、外周血WBC、Hb与Plt等差异均无统计学意义。结论术中持续输注右美托咪定0.5μg·kg-1·h-1有助于维持术中、术后苏醒期血流动力学平稳,尤其对于垂体无功能腺瘤患者更具有临床意义。
[Abstract]:Objective to observe the effect of dexmetomidine on hemodynamics in patients with different types of pituitary tumor resection. Methods A retrospective analysis of 60 patients undergoing transsphenoidal pituitary tumor resection in Beijing Union Hospital from August to November 2013 was performed. The patients were divided into two groups: right metomidine group (n = 24) and control group (n = 36). After anesthesia induction, dexmetomidine 0.5 渭 g kg-1 h-1 was injected intravenously until the end of operation, while the control group received routine general anesthesia. To further analyze the effect of dexmetomidine on hemodynamics in patients with pituitary adenoma resection. The changes of SBP DBP and HR were recorded before and after anesthesia (preoperatively, during the resection of pituitary adenoma (intraoperative) and during the recovery of anesthesia (postoperative), the changes of preoperative and postoperative WBC HbP Plt, body temperature before and after operation, and the dosage of fentanyl during the operation were recorded. Operation time, recovery time, hospitalization days, etc. Results compared with group C, SBPmaxand SBPmax-SBPmin in group D were significantly lower than those in group C, while in patients with pituitary adenoma, SBPmaxand SBPmin-DBPmin in patients with pituitary nonfunctional adenoma were significantly lower than those in group C and SBPmax-SBPmin-DBPmin in patients with pituitary nonfunctional adenoma was significantly lower than that in group C, and the HRmax of patients with pituitary nonfunctional adenoma was significantly lower than that of group C. There was no significant effect of dexmetomidine on hemodynamics in patients with growth hormone adenoma or Cushing's disease. There were no significant differences between the two groups in the dosage of fentanyl, the time of operation, the time of waking up, the days of hospitalization, the body temperature before and after operation, and the peripheral blood WBCCU HB and Plt. Conclusion continuous intraoperative infusion of dexmetidine 0.5 渭 g kg-1 h-1 is helpful to maintain the hemodynamics during the recovery period, especially in patients with pituitary nonfunctional adenoma.
【作者单位】：中国医学科学院北京协和医院麻醉科;西安医学院附属医院麻醉科;
【分类号】：R614;R736.4

【参考文献】