摘要
目的探讨应用盐酸右美托咪定对预防老年全麻腹部手术患者苏醒拔管期并发症及促进患者自主呼吸恢复等方面的价值。方法将2016年3月~2017年7月在我院接受全麻腹部手术的97例老年患者随机分为对照组48例和研究组49例,其中研究组患者手术结束前给予盐酸右美托咪定静脉泵入,对照组给予相同剂量的生理盐水泵注。比较两组患者给药前(T0)、拔管前(T1)、拔管后即刻(T2)、拔管后5min(T3)和拔管后10min(T4)的心率(HR)、平均动脉压(MAP)及Ramsay镇静评分变化情况,两组患者的自主呼吸恢复时间、拔管时间、睁眼时间,以及躁动发生情况。结果研究组患者T1-T4的HR、MAP和Ramsay镇静评分均明显优于对照组(P<0.05);研究组患者的自主呼吸恢复时间和拔管时间与对照组相比无统计学意义(P>0.05),睁眼时间明显短于对照组(P<0.05);研究组患者苏醒拔管期间躁动发生率为8.16%,明显低于对照组的25.00%(P<0.05)。结论在老年全麻腹部手术患者手术结束前应用盐酸右美托咪定能够有效抑制患者血流动力学波动,减少躁动的发生,同时还能一定程度地缩短患者的苏醒时间,其在提高患者苏醒拔管期安全性方面具有重要价值。
Objective To evaluate the clinical value of dexmedetomidine in the period of extubation in elderly patients undergoing abdominal operation complications and general anesthesia for abdominal operation. Methods Form March 2016 to July 2017,97 elderly patients undergoing abdominal surgery under general anesrhesia in our hospital were selected and divided into eontral group with 48 cases and study group with 49 cases,the patients in the study group were given HC1 dexmedetomidine intravenous infusion,the control group received the normal saline pump.The heart rate of before administration（T0）,before extubation（T1）,Immediately after extubation（T2）,5 minutes after extubation（T3） and 10 minutes after extubation（T3）,Mean arterial pressure,ramsay sedation score of recovery was compared between the two groups. Results The HR,MAP and Ramsay scores in the study group were significantly better than those in the control group at T1 to T4 （P 〈 0.05）;There was no significant difference between the study group and the control group in spontaneous breathing recovery time and extubation time （P 〈0.05）,but the opening time of the study group was significantly shorter than that of the control group （P〈 0.05）;The incidence of agitation during the course of extubation was significantly lower in the study group than in the control group （P 〈 0.05）. Conclusion Dexmedetomidine before the end of operation can effectively inhibit hemodynamic fluctuations, reduce the occurrence of restlessness,shorten the patient＇s recovery time,it has important value in improving the safety of patients during extubation.
出处
《中国医药科学》
2018年第1期152-154,168,共4页
China Medicine And Pharmacy
关键词
老年患者
全麻
腹部手术
苏醒拔管期
盐酸右美托咪定
Elderly patients
General anesthesia
Abdominal surgery
Awake extubation period
Dexmedetomidine hydrochloride
