右美托咪定对冠心病患者非心脏手术中血流动力学的影响和心肌保护作用

发布时间：2018-03-08 13:13

本文选题：右美托咪定　切入点：心肌功能　出处：《中国老年学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的探讨右美托咪定对冠心病患者非心脏手术中血流动力学的影响和心肌保护作用。方法择期行腹部手术的冠心病患者80例,按随机数字表法分为对照组和实验组各40例。实验组于麻醉诱导前、术中予以右美托咪定治疗,而对照组予以等容量的生理盐水。对两组麻醉前(T0)、插管时(T1)、手术开始时(T2)、手术开始后30 min(T3)、拔管时(T4)的心率(HR)、收缩压(SBP)、舒张压(DBP)进行比较,监测术中心电图ST段改变,并检测T1时血清肌钙蛋白(c Tn I)和糖原磷酸化酶(GP-BB)水平。结果两组手术过程中生命体征平稳,手术顺利完成。实验组气管插管时间及手术时间较对照组明显缩短,丙泊酚用量明显减少(P0.05)。两组T0时的生命体征差异不明显(P0.05),与对照组相比,实验组T1、T2、T3、T4时HR明显减慢,SBP、DBP明显降低(P0.05)。手术中实验组心电图ST段改变发生率较对照组明显降低(P0.05);实验组T1时血清c Tn I和GP-BB水平均较对照组明显降低(P0.05)。结论右美托咪定具有对冠心病患者全麻术的心肌保护和维持循环稳定的作用,可减轻冠心病患者手术麻醉期风险。
[Abstract]:Objective to investigate the effects of dexmetomidine on hemodynamics and myocardial protection in patients with coronary heart disease (CHD) after non-cardiac surgery. According to the method of random number table, the control group and the experimental group were divided into two groups: 40 cases in each group. The experimental group was treated with dexmetomidine before anesthesia induction. The control group was treated with normal saline of equal volume. The heart rate of the two groups were compared before anesthesia, during intubation, at the beginning of operation, 30 min after operation, 30 min after operation, 30 min after operation, and 30 min after extubation. Systolic blood pressure (SBP) and diastolic pressure (DBP) were compared, and the changes of St segment of electrocardiogram (ECG) were monitored. The serum levels of cTnI and GP-BBB were measured at T1. Results the vital signs of the two groups were stable and the operation was completed successfully. The tracheal intubation time and the operative time in the experimental group were significantly shorter than those in the control group. The dosage of propofol decreased significantly (P 0.05). There was no significant difference in vital signs between the two groups at T0, and there was no significant difference in vital signs between the two groups compared with the control group. The HR of experimental group T _ 1 T _ (2) T _ (2) T _ (3) T _ (4) was significantly slower than that of control group (P _ (0.05)). The incidence of St segment changes in electrocardiogram in the experimental group was significantly lower than that in the control group, and the serum levels of c TnI and GP-BB in the experimental group were significantly lower than those in the control group at T _ 1. Conclusion right metoprolol is significantly lower than that in the control group. Midine has the effect of protecting myocardium and maintaining circulatory stability in patients with coronary heart disease after general anesthesia. It can reduce the risk of anesthesia in patients with coronary heart disease.
【作者单位】：重庆医科大学附属永川医院麻醉科;
【基金】：重庆市永川区软科学研究计划项目(No.Ycstc,2014rc9006)
【分类号】：R614

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