摘要
目的分析甲状腺手术患者在全麻拔管期间应用右美托嘧啶(Dexmedetomidine,DEX)对患者的影响。方法选取2010年12月至2012年12月收治的174例甲状腺手术患者,按照随机数字表分为观察组及对照组,每组87例,分别在全麻气管插管拔管期间给予DEX及0.9%氯化钠溶液注射,比较2组患者手术过程中血压、心率及血氧饱和度变化,并观察其不良反应发生情况。结果 2组患者手术时间、睁眼时间及拔管时间差异无明显统计学意义(P>0.05);2组患者T3、T4均见心率、收缩压升高,对照组升高更为明显(P<0.05),其各项生理指标在T5均恢复麻醉前水平;观察组术后1 h BCS评分显著高于对照组,其视觉模拟评分显著低于后者(P<0.05),随时间变化,对照组BCS评分逐渐上升,术后4 h 2组患者舒适评分差异无统计学意义(P>0.05);观察组呛咳、恶心、呕吐发生率低于对照组,其心动过缓、低血压发生率高于对照组(P<0.05)。结论甲状腺手术患者全麻拔管期间应用DEX可获得较好的镇痛、镇静效果,能够有效降低呛咳、恶心、呕吐等不良反应发生率,增加患者术后舒适度,对于DEX应用后带来的心动过缓、低血压等不良反应,可予以补液等常规治疗纠正,安全性良好。
Objective To analyze the effect of application of dexmedetomidine（ DEX） during general anesthesia extubation on the patients receiving thyroid operation. Methods One hundred and seventy-four patients receiving thyroid operation who were admitted into our hospital from December 2010 to December 2012 were divided into observation group and control group according to random digits table,with 87 patients in each group. The patients in observation group and control group were given DEX and 0. 9% sodium chloride solution injection during general anesthesia tracheal intubation and extubation,respectively. The blood pressure,heart rate（ HR）,blood oxygen saturation and incidence of adverse reactions were observed and compared between two groups. Results There were no significant differences in the operation time,eye opening time and extubation time between two groups（ P 〈0. 05）. The HR and systolic blood pressure at T3,T4 were increased in both groups,moreover,which in control group were significantly increased（ P 〈0. 05）. The other physiological indexes were recovered to preanesthesia levels at T5. The BCS one hour after operation in observation group was significantly higher than that in control group,however,visual simulation score in observation group was significantly lower than that in control group（ P 〈0. 05）. The BCS score in control group was gradually increased with time changes,there was no significant differences in comfort score 4h after operation between two groups,the incidences of bucking,nausea,vomiting in observation group were lower than those in control group,however,the incidences of bradycardia and hypotension were significantly higher than those in control group（ P 〈0. 05）. Conclusion The application of DEX in thyroid patients with general anesthesia operation during extubation can obtain satisfactory antinociceptive and sedative effects,and can effective decrease the incidences of bucking,nausea,vomiting,and can increase the comfort degree of patients after operation.
出处
《河北医药》
CAS
2015年第12期1776-1778,共3页
Hebei Medical Journal
关键词
甲状腺手术
气管插管
拔管
右美托嘧啶
影响
thyroid operation
tracheal intubation
extubation
dexmedetomidine
influence
