右美托咪定复合七氟烷对高血压患者应激反应的影响

发布时间：2018-01-21 07:22

本文关键词： 右美托咪定七氟烷高血压应激反应　出处：《重庆医学》2017年12期 　论文类型：期刊论文

【摘要】：目的观察右美托咪定复合七氟烷麻醉对高血压患者围术期不同时间点血流动力学及血糖、白细胞介素6(IL-6)及肿瘤坏死因-α(TNF-α)的影响。方法择期腔镜胆囊切除术的高血压患者90例,分为两组(n=45):右美托咪定组(Dex组)气管插管前10min恒速泵注0.8μg/kg右美托咪定作为负荷量,随后0.8μg·kg-1·h-1持续泵注至胆囊切除;对照组(C组)以乳酸林格氏液泵注,两组患者均以吸入七氟烷诱导麻醉。监护未用药时(T0),气管导管放置前1min(T1)、插管后5min(T2),气腹后20min(T3),拔除气管导管后20min(T4)时心率(HR)、平均动脉压(MAP);同一时点检测静脉血葡萄糖、TNF-α及IL-6浓度。结果与T0相比,Dex组T2、T3、T4时点HR、MAP变化不明显,而C组显著升高(P0.05);Dex组T2、T3、T4时点HR、MAP显著降低于C组(P0.05)。两组T3、T4时点血糖、IL-6、TNF-α显著高于同组T0时刻(P0.05),但Dex组显著低于C组(P0.05)。结论高血压患者腹腔镜胆囊切除术采用右美托咪定复合七氟烷麻醉,可以保持血流动力学稳定并减轻麻醉及手术导致的过度应激。
[Abstract]:Objective to observe the effect of dexmetomidine combined with sevoflurane anesthesia on hemodynamics and blood glucose in patients with hypertension at different time points during perioperative period. Effect of interleukin 6 (IL 6) and tumor necrosis factor 伪 (TNF- 伪). Methods 90 patients with hypertension underwent selective endoscopic cholecystectomy. Two groups were divided into two groups: dexmetomidine group and Dex group. Ten minutes before intubation, 0.8 渭 g / kg dexmetomidine was injected by constant velocity pump as the load. Then 0. 8 渭 g 路kg-1 路h-1 continuous pump was injected into cholecystectomy. The control group (group C) was injected with Ringer's lactate liquid pump, and both patients were anesthetized by inhaling sevoflurane. Heart rate and mean arterial pressure were observed at 5 min after intubation and 20 min after pneumoperitoneum, 20 min after extubation and 20 min after T4). The concentrations of TNF- 伪 and IL-6 in venous blood were detected at the same time. Results compared with T0, the changes of HRMAP in T2T3 and T4 in Dex group were not obvious. Group C significantly increased P0.05A; The map of Dex group was significantly lower than that of group C (P 0.05) and IL-6 at T _ 3 / T _ 4. TNF- 伪 was significantly higher than that in the same group (P0.05). Conclusion Laparoscopic cholecystectomy with dexmetomidine combined with sevoflurane was used in patients with hypertension after laparoscopic cholecystectomy. Maintain hemodynamic stability and reduce stress caused by anesthesia and surgery.
【作者单位】：遵义市第一人民医院麻醉科;遵义医学院第三附属医院麻醉科;
【基金】：遵义市科技局联合研发资金项目:遵市科合社字[(2012)5号]
【分类号】：R614
【正文快照】： 我国手术患者合并高血压病的比例逐年增大,提高手术时间短、麻醉手术过程应激强的高血压患者的麻醉质量是临床的难题。右美托咪定可增加围术期血流动力学的稳定性并减轻炎症反应[1-2];七氟烷因诱导快、苏醒快、可控性好、降低应激反应被广泛应用于临床麻醉[3-4]。本研究拟采用

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