摘要
目的:为了观察和探讨盐酸右美托咪定对高血压患者实施腹腔镜全子宫切除术围术期血流动力学变化及术后恢复质量的影响。方法:选择ASA分级Ⅱ~Ⅲ级,高血压分级1~2级妇科患者100例随机分为右美托咪定组(D组,n=50)和对照组(C组,n=50)。右美托咪定组(D组)予以0.5μg/kg右美托咪定在麻醉诱导前15 min泵注完毕,后改为0.3μg/(kg·h)泵注直至子宫韧带剥离完毕。对照组(C组)予以等量0.9%氯化钠溶液泵注。采用无创血流动力学检测仪(Bio Z-2011)分别记录给药前即刻(T0)、插管前即刻(T1)、插管后即刻(T2)、手术开始时即刻(T3)、术中1 h(T4)、术毕即刻(T5)、拔管即刻(T6)、拔管后5 min(T7)患者的心输出量(CO)、外周血管阻力(SVR)及心率(HR)。拔管后2 h采用40项术后恢复质量调查问卷(QoR-40)进行术后回访。结果:两组患者不同时点CO、SVR、HR与T0的差值比较,差异有统计学意义(P<0.05)。两组患者拔管后2 h进行术后回访,右美托咪定组(D组)术后恢复质量调查问卷(QoR-40)评分明显高于对照组(C组),差异具有统计学意义(P<0.05)。结论:盐酸右美托咪定减轻高血压患者围术期心血管反应和稳定血流动力学,且可在一定程度上提高术后恢复质量。
Objective To find the influence of dextral metadecine on perioperative hemodynamics and postoperative recovery quality in hypertensive patients undergoing laparoscopic hysterectomy,including center output（ CO）,peripheral vascular resistance（ SVR）,heart rate（ HR） and 40 postoperative recovery quality questionnaires（ QoR-40）. Methods One hundred gynecological patients with ASA grade Ⅱ ~ Ⅲ and hypertension grade 1 - 2 were randomly assigned to receive dextral metadecine（ Group D,n = 50） and control group（ Group C,n = 50）. Group D was given 0.5 μg/kg dexmeidine in the first 15 min before anesthesia induction,and then 0. 3 μg/（ kg·h） till 40 minutes before the end of the operation. The control group（ Group C） was injected with equal volume of 0.9% sodium chloride solution. Patient＇s CO,SVR and HR were recorded using non-invasive hemodynamic detector（ Bio Z-2011） before administration（ T0）,immediately before intubation（ T1）,immediately after intubation（ T2）,immediately after operation（ T）,during operation（ T4）,immediately after operation（ T5）,immediately after extubation（ T6）,and 5 min after extubation（ T7）. Two hours after extubation,QoR-40 was used for postoperative follow-up. Results The difference of CO,SVR and HR between the two groups of patients at different time points was statistically significant（ P〈0.05）. The QoR-40 score of group D was higher than the control group（ Group C）,and the difference was statistically significant（ P〈0.05）. Conclusion Dextral metadecine can stabilize the hemodynamic fluctuation during perioperative period of hypertensive patients and improve postoperative recovery quality to a certain extent.
作者
刘颖
罗辉宇
张振
吴金晶
杨力
LIU Ying;LUO Hui-yu;ZHANG Zhen;WU Jin- jing;YANG Li(The First Renmin Hospital of Xiangyang City, Xiangyang, Hubei 441000, China)
出处
《湖北医药学院学报》
CAS
2017年第6期525-528,共4页
Journal of Hubei University of Medicine
