摘要
目的探讨右美托咪定对全麻子宫切除患者血流动力学及应激反应的影响。方法将实施子宫切除术患者66例随机数字法分为对照组与观察组,对照组给予生理盐水,观察组给予右美托咪定(DEX),观察并记录麻醉前15 min(T_0)、插管后5min(T_1)、气腹后20 min(T_2)、术后立刻(T_3)及术后24 h(T_4)的平均动脉压(MAP)和心率(HR);同时间点取外周静脉血测定皮质醇(Cor)、去甲肾上腺素(IL-6)及白介素6(IL-6)的含量。结果对照组T_1、T_2和T_3时刻的MAP、HR水平均较T_0时刻升高(P<0.05),观察组略微升高;组间比较,对照组T_1、T_2和T_3时刻MAP、HR升高程度明显于观察组(P<0.05)。T_2、T_3和T_4时刻的Cor、IL-6较T_0时刻明显升高(P<0.05),T_2、T_3时刻的NE较T_0时刻明显升高(P<0.05),观察组略微升高;组间比较,对照组T_2、T_3时刻Cor、NE及IL-6升高程度明显大于观察组(P<0.05)。结论 DEX有利于全麻子宫切除患者的血流动力学稳定及降低术中的应激反应。
OBJECTIVE To explore the influence of dexmedetomidine（DEX） on haemodynamics and stress response of patients withhysterectomy under general anesthesia. METHODS A total of 66 patients with hysterectomy under general anesthesia were divided in-to control group treated with normal saline and observation group with DEX by random number table. Mean arterial pressure（MAP）and heart rate（HR） 15 min before anesthesia（T_0）, 5 min after intubation（T_1）, 20 min after pneumoperitoneum（T_2）, immediately aftersurgery（T_3） and after postoperative 24 h（T_4） were observed and recorded. Peripheral venous blood was collected at same time pointsto detect the levels of cortisol（Cor）, norepinephrine（NE） and interleukin-6（IL-6）. RESULTS MAP and HR were markedly higher at T_1, T_2 and T_3 than T_0 in control group（P〈0.05）, but increased slightly in observation group. Intergroup comparison showed that con-trol group was notably higher than observation group in MAP and HR at T_1, T_2 and T_3（P〈0.05）. Levels of Cor and IL-6 increasedmore significantly at T_1, T_2 and T_3 than T_0（P〈0.05）, while NE increased prominently at T_2 and T_3 than T_0 in control group（P〈0.05）,which increased slightly in observation group. Intergroup comparison suggested that control group was prominently higher than obser-vation group in levels of Cor, NE and IL-6 at T_2 and T_3（P〈0.05）. CONCLUSION DEX was beneficial to stabilizing the haemodynam-ics and reducing the intra-operative stress response of patients with hysterectomy under general anesthesia.
出处
《中国初级卫生保健》
2017年第6期78-79,共2页
Chinese Primary Health Care
基金
甘肃省卫生行业计划项目(GSWSKY-2016-12)
关键词
右美托咪定
全麻子宫切除
血流动力学
应激反应
dexmedetomidine
hysterectomy under general anesthesia
haemodynamics
stress response
