摘要
目的观察不同浓度右美托咪定对老年肺叶切除术患者应激性反应的影响。方法选择60例需行肺叶切除术的老年患者作为研究对象，按照配对分组法分为3组，每组20例，于诱导前给予不同浓度右美托咪定泵注，其中，A组0．4μg／kg，B组0．6μg／kg，C组0．8μg／kg，泵注时间10min，均给予长托宁、丙泊酚、芬太尼、顺阿曲库铵诱导，行双腔管插管后，泵注丙泊酚、瑞芬太尼、顺阿曲库铵维持麻醉深度，并维持BIS于40～60左右，比较3组患者手术不同时刻血流动力学相关指标，并测定皮质醇浓度评估应激性反应。结果插管后、摆侧卧位后、切皮时、术中1h、拔管即刻A组心率、平均动脉压均高于B组、C组，且B组高于C组，B组患者心率、血压更为平稳，均P〈0．05。A组插管后、拔管即刻皮质醇浓度均高于B组、C组，均P〈0．05。B组插管后、摆侧卧位后、切皮时、术中1h、手术结束时、拔管即刻皮质醇浓度均高于c组，均P〈0．05。结论泵注0．6μg／kg右美托咪定应用于肺叶切除术，患者血流动力学更为稳定，可有效抑制术中应激性反应，具有重要的临床价值。
Objective To observe the effect of different concentrations of dexmedetomidine on of stress reaction in elderly patients undergoing pulmonary lobectomy. Methods Sixty cases of elderly patients needed pulmonary lobectomy were se- lected as the research objects, according to the matching grouping method they were divided into three groups with each group of 20 cases. Before inducting give different concentrations of dexmedetomidine infusion. The group A, B, and C were adopted 0.4μg/kg,0.6 μg/kg, and 0.8μg/kg, respectively, while pump injection for 10 min. All patients were given penehyclidine, propofol, fentanyl, cisatracurium for induction. Adopted double cavity intubation give propofol, remifentanil, cisatracurium for maintain depth of anesthesia, and maintain the BIS around 40 - 60, to compare hemodynamic indexes a- mong three groups of patients at different time, and determine cortisol concentrations to assess stress reaction. Results After intubation, after placing lateral decubitus position, intraoperative 1 h and pull tube immediately, the heart rate and mean arterial pressure in group A were higher than those in group B, group C and group B was higher than those in group C, group B＇ blood pressure and heart rate were more stable, all P 〈 0.05. The concentrations of cortisol in A group were higher than those in B and group, C group, and P 〈 0.05. After intubation, lateral position, skin incision, intraoperative 1 h, operation at the end and pull tube immediate cortisol concentrations were higher than that in group C, P 〈 0.05. Con- clusion Hemodynamics after infusion of 0.6μg/kg dexmedetomidine in patients undergoing lobectomy is more stable, and it can effective intraoperative stress response, so it has important clinical value.
出处
《中华全科医学》
2016年第1期57-59,共3页
Chinese Journal of General Practice
关键词
右美托咪定
老年患者
肺叶切除术
应激性
Dexmedetomidine
Elderly patients
Pulmonary lobectomy
Stress response
