摘要
目的探讨消化道肿瘤患者手术治疗期间行盐酸右美托咪定超前镇静的效果及价值。方法选取2019年1月至2021年12月择期行手术治疗的80例消化道肿瘤患者作为对象。通过随机数字表法分为观察组和对照组,每组40例。观察组麻醉前15 min使用盐酸右美托咪定进行超前镇静。对照组麻醉前15 min使用0.9%氯化钠溶液。观察患者手术指标及围术期机体应激反应、血流动力学变化情况及镇痛和镇静效果、术后麻醉并发症发生情况。结果观察组术中芬太尼用量与对照组比较明显减少,差异有统计学意义(P<0.05);观察组诱导前15 min、诱导前即刻及气腹建立、拔管即刻观察组血糖(Glu)、肾上腺素(E)、白介素-6(IL-6)及血清皮质醇(Cor)水平比对照组均明显降低,差异有统计学意义(P<0.05);观察组拔管时HR及SBP、DBP水平与麻醉前比较均无明显变化,RR、SpO2水平在麻醉前、拔管时、拔管均无明显变化,差异无统计学意义(P>0.05),拔管后30 min HR、SBP、DBP均基本恢复到拔管前水平;观察组DEX负荷量毕及术后1 h、48 h、72 h的VAS评分均明显低于对照组,DEX负荷量毕、术后1 h的Ramsay评分均明显高于对照组,差异均有统计学意义(P<0.05);观察组术后麻醉并发症总发生率为5.00%(2/40),明显低于对照组的25.00%(30/40),差异有统计学意义(P<0.05)。结论选择手术方式给予消化道肿瘤患者治疗时行盐酸右美托咪定超前镇静,能够明显减轻患者机体应激反应,保证患者血流动力学维持在良好稳定状态,且有效提高镇痛及镇静效果,减少患者术后相关麻醉并发症,有助于患者术后恢复速度缩短和康复效果提高。
Objective To investigate the effect and application value of preemptive sedation with dexmedetomidine hydrochloride in patients with digestive tract tumor during operation.Methods A total of 80 patients with digestive tract tumor who underwent selective operation in our hospital from January 2019 to December 2020 were enrolled in the study,who were divided into observation group and control group according to the random number table,with 40 cases in each group.The patients in observation group were treated by dexmedetomidine hydrochloride at 15min before anesthesia,however the patients in control group were given normal 0.9%sodium chloride solution instead.Results The dosage of fentanyl in observation group was significantly less than that in control group(P<0.05).The levels of blood glucose(Glu),adrenaline(E),interleukin 6(IL-6)and serum cortisol(Cor)in observation group at 15min before induction,immediately after induction,and establishment of pneumoperitoneum,immediately after extubation were significantly lower than those in control group(P<0.05).However there were no significant differences in the levels of HR,SBP,DBP,RR and SpO2 in observation group between extubation time and before anesthesia(P>0.05).At 30 min after extubation,the levels of HR,SBP and DBP were recovered to the levels before extubation.The VAS scores in observation group at finishing Dex load,and at 1h,48h and 72h after operation were significantly lower than those in control group,moreover the Ramsay scores at finishing Dex load and 1 hour after operation in observation group were significantly higher than those in control group(P<0.05).In addition the total incidence of postoperative complications in observation group was was significantly lower than that in control group(5.00%vs 25.00%,P<0.05).Conclusion The preemptive sedation with dexmedetomidine hydrochloride during operation for the patients with digestive tract tumors can significantly relieve the stress response of patients,ensure that the hemodynamics at stable state,and effectiv
作者
齐超
张哲哲
张晓玲
骆洪雁
刘红曼
张孟田
QI Chao;ZHANG Zhezhe;ZHANG Xiaoling(Department of Anesthesiology,Langfang People’s Hospital,Hebei,Langfang 065000,China;不详)
出处
《河北医药》
CAS
2021年第15期2284-2287,2292,共5页
Hebei Medical Journal
关键词
消化道肿瘤
超前镇静
盐酸右美托咪定
应激反应
血流动力学
镇痛
镇静
并发症
digestive tract tumor
advanced sedation
dexmedetomidine
stress reaction
hemodynamics
analgesia
sedation
complications
