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(P<0.05);T_1~T_4时D组NE、E、Cor、IL-6、T_NF-α浓度明显低于C组(P<0.05);D组拔管期呛咳发生率为9例(30%),明显低于C组的21例(70%)(P<0.05)。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。
Objective To observe the effects of dexmedetomidine on the perioperative stress in patients undergoing uvulopalatopharyngoplasty（UPPP）.Methods Sixty patients scheduled for uvulopalatopharyngoplasty（UPPP）,all males,aged 18-65 years,of ASA physical statusⅠ orⅡ,were selected randomly.Then the patients were divided into dexmedetomidine group（group D）and control group（group C）,30 patients in each group.The patients of group D were administered 1.0μg/kg bolus dose of dexmedetomidine over 10 min before tracheal intubation,followed by 0.5μg·kg^-1·h^-1infusion for 12 hours in ICU after surgery.And the patients in group C were given normal saline instead as in group D.The levels of MAP,HR,PaO2,PaCO2,norepinephrine（NE）,epinephrine（E）,cortisol（Cor）,interleukin-6（IL-6）and tumor necrosis factor-α（TNF-α）were recorded at time points of entering operating room（T0）,tracheal intubation（T1）,30 min after operation（T2）,upon entering ICU（T3）,and extubation（T4）.Results HR of group D was significantly slower than that of group C during T1-T4（P〈0.05）.MAP of group D was lower than that of group C during T1-T4（P〈0.05）.The levels of NE,E,Cor,IL-6,TNF-αof group D were significantly lower than that of group C during T1-T4（P〈0.05）.Compared with group C [21（70%）],the incidence of cough reflex during extubation was lower in group D significantly[9（30%）]（P〈0.05）.Conclusion Intravenous infusion of dexmedetomidine can suppress perioperative stress effectively and stabilize hemodynamics for the patients undergoing UPPP without prolonging the recovering time,extubation time and the duration in ICU.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2017年第8期738-741,共4页
Journal of Clinical Anesthesiology
关键词
右美托咪定
腭咽成形术
应激反应
Dexmedetomidine
Uvulopalatopharyngoplasty
Stress reaction
