摘要
目的 探讨右美托咪定复合全麻对钬激光碎石术(HLL)患者苏醒质量、应激指标、纤溶功能指标、疼痛程度的影响。方法 随机将2020年1月至2021年10月郑州市第三人民医院收治的95例HLL患者分为复合组(49例)和全麻组(46例)。全麻组接受全身麻醉,复合组接受右美托咪定复合全身麻醉。对比两组苏醒质量、各时间[麻醉前(T0)、麻醉后10 min(T1)、手术进行时(T2)、术后30 min(T3)]应激指标、术前及术后6、12、24 h纤溶功能指标、疼痛程度(VAS评分)及不良反应情况。结果 复合组自主呼吸恢复时间、睁眼时间、定向力恢复时间短于全麻组(P<0.05);T1、T2、T3时复合组血清促肾上腺皮质激素(ACTH)、肾上腺素(EPI)、皮质醇(Cor)水平低于同期全麻组(P<0.05);复合组术后6、12、24 h血清组织型纤溶酶原激活物(T-PA)、纤溶酶原激活物抑制剂-1(PAI-1)、D-二聚体(D-D)水平和VAS评分低于同期全麻组(P<0.05);复合组不良反应总发生率(10.20%)与全麻组(23.91%)比较,差异无统计学意义(P>0.05)。结论 采用右美托咪定复合全麻安全可靠,能降低HLL患者应激反应程度,缓解疼痛,减轻纤溶功能损伤,有助于改善血液循环,提高患者苏醒质量。
Objective To explore the effect of dexmedetomidine combined with general anesthesia on the recovery quality, stress index, fibrinolytic function index and pain degree of patients with holmium laser lithotripsy(HLL). Methods A total of 95 HLL patients in Zhengzhou Third People’s Hospital from January 2020 to October 2021 were randomly divided into a compound group(49 cases) and a general anesthesia group(46 cases). The general anesthesia group was given general anesthesia, and the compound group was given dexmedetomidine combined with general anesthesia. The quality of recovery, time [before anesthesia(T0), 10 minutes after anesthesia(T1), during operation(T2) and 30 minutes after operation(T3)] stress indicators, preoperative and postoperative 6, 12 and 24 hours fibrinolytic function indexes, pain level(VAS score) and adverse reactions. Results The recovery time of spontaneous breathing, eye opening and orientation recovery in the compound group were shorter than those in the general anesthesia group(P<0.05). The serum levels of adrenocorticotropic hormone(ACTH), epinephrine(EPI), and cortisol(Cor) in the compound group at T1, T2and T3were lower than those in the general anesthesia group at the same period(P<0.05). Serum levels of tissue-type plasminogen activator(T-PA), plasminogen activator inhibitor-1(PAI-1), D-dimer(D-D) level and VAS scores of the compound group at 6, 12 and 24 hours after operation were lower than those of the general anesthesia group at the same period(P<0.05). There was no significant difference in the total incidence of adverse reactions in the compound group(10.20%) compared with the general anesthesia group(23.91%)(P>0.05). Conclusion Dexmedetomidine combined with general anesthesia in HLL is safe and reliable, can reduce the degree of stress response, relieve pain, reduce the damage of fibrinolytic function, help to improve blood circulation, and improve the quality of patients’ recovery.
作者
吕锦如
张瑞波
Lü Jinru;ZHANG Ruibo(Department of Anesthesiology,Zhengzhou Third People’s Hospital,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2023年第1期78-81,共4页
Henan Medical Research
关键词
钬激光碎石术
右美托咪定
苏醒质量
纤溶功能
holmium laser lithotripsy
dexmedetomidine
recovery quality
fibrinolytic function
