右美托咪定对腭咽成形术患者围术期应激反应的影响

发布时间：2018-04-05 14:26

本文选题：右美托咪定　切入点：腭咽成形术　出处：《临床麻醉学杂志》2017年08期

【摘要】：目的观察右美托咪定对腭咽成形术(uvulopalatopharyngoplasty,UPPP)患者围术期应激反应的影响。方法选择择期行腭咽成形术的男性患者60例,年龄18~65岁,ASAⅠ或Ⅱ级,随机分为右美托咪定组(D组)和对照组(C组),每组30例。D组气管插管前先予负荷剂量右美托咪定1.0μg/kg 10min,术中及入ICU后持续静脉泵注右美托咪定0.5μg·kg~(-1)·h~(-1);C组持续泵入等容量生理盐水。记录入室(T_0)、气管插管成功即刻(T_1)、手术开始30min(T_2)、入ICU即刻(T_3)、拔除气管导管即刻(T_4)的MAP、HR;检测T_0~T_4时动脉血PaO_2、PaCO_2及去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)、IL-6、T_NF-α的浓度;记录入ICU后苏醒时间、拔管时间、ICU停留时间及呛咳反应的发生情况。结果 T_1~T_4时D组HR明显慢于C组,MAP明显低于C组(P0.05);T_1~T_4时D组NE、E、Cor、IL-6、T_NF-α浓度明显低于C组(P0.05);D组拔管期呛咳发生率为9例(30%),明显低于C组的21例(70%)(P0.05)。两组苏醒时间、拔管时间及ICU停留时间差异无统计学意义。结论围术期静脉泵注右美托咪定可有效抑制腭咽成形术患者的应激反应,维持循环稳定,且不延长患者苏醒时间、拔管时间及ICU停留时间。
[Abstract]:Objective to observe the effect of dexmetomidine on perioperative stress response in patients with palatopharyngoplasty.Methods A total of 60 male patients with selective palatopharyngoplasty, aged 18 to 65, were enrolled in this study.They were randomly divided into two groups: group D (n = 30) and group C (n = 30). Each group (n = 30) received dexmetomidine 1.0 渭 g/kg for 10 minutes before intubation. During and after ICU, intravenous infusion of dexmetomidine 0.5 渭 g kg-1) was continuously injected into the same volume of normal saline.The duration of extubation, the duration of stay in ICU and the occurrence of cough reaction.Results at T_1~T_4, HR in group D was significantly slower than that in group C (P 0.05) and map in group D was significantly lower than that in group C (P 0.05). The concentration of IL-6T in group D was significantly lower than that in group C (P 0.05). The incidence of cough choking in group D during extubation was significantly lower than that in group C (P 0.05), and was significantly lower than that in group C (n = 21).There was no significant difference in recovery time, extubation time and ICU residence time between the two groups.Conclusion intravenous infusion of dexmetidine during perioperative period can effectively inhibit the stress response of patients with palatopharyngoplasty, maintain stable circulation, and not prolong the recovery time, extubation time and ICU residence time of patients with palatopharyngoplasty.
【作者单位】：南京医科大学第一附属医院麻醉科;
【分类号】：R614

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