右美托咪定与丙泊酚麻醉在肝癌介入术中的应用效果比较

发布时间：2018-06-22 18:00

本文选题：肝肿瘤 + 介入手术　；参考：《山东医药》2016年41期

【摘要】：目的比较以右美托咪定及丙泊酚为主的两种麻醉性监护方法用于经皮穿刺肝癌介入术的效果。方法选择48例限期进行经皮穿刺肝癌介入手术的患者,随机分为右美托咪定组和丙泊酚组,分别接受右美托咪定和丙泊酚复合瑞芬太尼持续泵注进行麻醉性监护。观察并记录患者术前、术中及术后平均动脉压、心率、呼吸频率、脉搏氧饱和度、BIS值,术中瑞芬太尼用量,术前、术后动脉血CO2分压(Pa CO2)改变。结果两组患者术中均得到充分镇静,血压、心率、脉搏氧饱和度较术前差异无统计学意义(P均0.05)。丙泊酚组术中呼吸频率较术前明显减慢,与右美托咪定组相比差异有统计学意义(P0.01)。右美托咪定组阿片类药物的用量显著少于丙泊酚组(P0.01)。丙泊酚组患者术后Pa CO2增值高于右美托咪定组,差异有统计学意义(P0.01)。结论与丙泊酚相比,右美托咪定能为肝癌介入手术提供更好的呼吸稳定性,同时减少阿片类药物的用量。
[Abstract]:Objective to compare the effects of two kinds of anesthetic monitoring methods, dexmetomidine and propofol. Methods Forty-eight patients with liver cancer undergoing percutaneous interventional surgery were randomly divided into two groups: dexmetomidine group and propofol group. The patients received dexmetomidine and propofol combined with remifentanil continuous pump for anesthesia monitoring. The mean arterial pressure, heart rate, respiratory frequency, pulse oxygen saturation and the dosage of remifentanil were observed and recorded before, during and after operation. The changes of arterial blood CO _ 2 (Paco _ 2) were observed before and after operation. Results there was no significant difference in sedation, blood pressure, heart rate and pulse oxygen saturation between the two groups (P 0.05). The intraoperative respiratory rate in propofol group was significantly slower than that before operation, and there was a significant difference compared with dexmetomidine group (P0.01). The dosage of opioids in dexmetomidine group was significantly lower than that in propofol group (P 0.01). In propofol group, the increase of Paco _ 2 was significantly higher than that in dexmetomidine group (P0.01). Conclusion compared with propofol, dexmetomidine can provide better respiratory stability and reduce the dosage of opiates in interventional surgery for liver cancer.
【作者单位】：山东大学第二医院;
【分类号】：R614;R735.7

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