摘要
目的:探讨丙泊酚复合右美托咪定用于食道超声心动图(TEE)引导的经皮房间隔缺损(ASD)封堵手术的效果。方法:选取2018年3月至2021年2月福建医科大学附属泉州第一医院收治的ASD患者90例,简单随机化法分为观察组和对照组,每组45例。对照组予以气管插管全麻,观察组予以丙泊酚复合右美托咪定。比较两组患者镇静、苏醒质量、不同时间点脑电双频指数(BIS)值、心率(HR)、平均动脉压(MAP)、氧化应激情况、不良反应发生率。结果:两组患者清醒镇静评分(OAA/S)比较,差异无统计学意义(P>0.05),观察组患者苏醒时间短于对照组,苏醒评分高于对照组,差异具有统计学意义(P<0.05)。两组患者同时间点BIS值比较,差异无统计学意义(P>0.05);术毕(T4)时,观察组患者HR、MAP低于对照组,差异具有统计学意义(P<0.05)。术后1 d,观察组患者超氧化物歧化酶(SOD)水平高于对照组,丙二醛(MDA)水平低于对照组,差异具有统计学意义(P<0.05)。观察组患者咽痛发生率低于对照组,差异具有统计学意义(P<0.05)。结论:丙泊酚复合右美托咪定用于TEE引导的经皮ASD封堵手术,可达到与全麻相似的镇静效果,有助于抑制氧化应激,维持血流动力学稳定,提高苏醒质量,减少不良反应。
Objective To investigate the efficacy of propofol combined with dexmedetomidine in transesophageal echocardiography(TEE)guided percutaneous atrial septal defect(ASD)closure.Methods A total of 90 patients with ASD admitted to Quanzhou First Hospital affiliated to Fujian Medical University from March 2018 to February 2021 were selected and divided into observation group and control group by simple randomization method,with 45 patients in each group.The control group was given endotracheal intubation and general anesthesia,and the observation group was given propofol combined with dexmedetomidine.The quality of sedation,recovery,bispectral index(BIS),heart rate(HR),mean arterial pressure(MAP),oxidative stress and incidence of adverse reactions were compared between two groups.Results There was no significant difference in awake sedation score(OAA/S)between the two groups(P>0.05).The time to wake up in the observation group was shorter than that in the control group,and the awake score was higher than that in the control group,with statistical significance(P<0.05).There was no significant difference in BIS value between two groups at the same time point(P>0.05).At the end of operation(T4),HR and MAP in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).One day after surgery,superoxide dismutase(SOD)level in the observation group was higher than that of the control group,monochrome display adapter(MDA)level was lower than that of the control group,the difference was statistically significant(P<0.05).The incidence of sore throat in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Propofol combined with dexmedetomidine can achieve sedation effect similar to that of general anesthesia in TEE-guided percutaneous chamber closure,which is helpful to inhibit oxidative stress,maintain hemodynamic stability,improve the quality of recovery,and reduce adverse reactions.
作者
黄淮
杨顺章
HUANG Huai;YANG Shun-zhang(Quanzhou First Hospital Affiliated to Fujian Medical University,Fujian Quanzhou 362000)
出处
《深圳中西医结合杂志》
2021年第21期98-100,共3页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
房间隔缺损
丙泊酚
右美托咪定
经食道超声心动图
经皮房间隔缺损封堵手术
Atrial septal defect
Propofol
Dexmedetomidine
Transesophageal echocardiography
Percutaneous closure of atrial septal defect
