摘要
目的研究右美托咪定联合舒芬太尼麻醉方案在经食道超声心动图(TEE)右心声学造影(c-TEE)诊断卵圆孔未闭(PFO)中的应用价值。方法选择十堰市人民医院因不明原因偏头痛、疑脑卒中就诊,并在超声科行常规经胸超声心动图(c-TTE)初步筛查的存在右向左分流(RLS)的患者194名,收集患者一般资料。前期50名患者采用传统无痛丙泊酚麻醉方案(丙泊酚组)、后期采用右美托咪定+舒芬太尼麻醉方案(改良组),比较两组患者插管反应[血压(BP)、心率(HR)、脉搏血氧饱和度(SpO_(2))等变化]及不良反应发生情况,同时比较两种麻醉方案下的TEE对PFO的诊断效能,包括二维结构清晰显示情况、右向左分流的检出情况及定量诊断。结果改良组插管反应及不良反应(如嗜睡、头晕等)发生率低于丙泊酚组(P<0.05),但每组患者插管前后HR、BP、SpO_(2)比较,差异无统计学意义(P>0.05);改良组TEE二维结构显示清晰度高于丙泊酚组,在解剖学危险因素显示上二者比较,差异有统计学意义(χ^(2)=18.85,P<0.001),但在两层隔结构清晰度显示上比较,差异无统计学意义(χ^(2)=1.12,P=0.291);两组c-TEE诊断PFO-RLS检出率比较,差异有统计学意义(χ^(2)=16.20,P<0.001),且改良组高于丙泊酚组;丙泊酚组c-TTE与c-TEE诊断PFO-RLS检出率比较,差异有统计学意义(χ^(2)=9.89,P<0.001),而改良组比较,差异无统计学意义(χ^(2)=3.03,P=0.082)。结论在右美托咪定联合舒芬太尼麻醉方案下进行c-TEE具有不良反应少、二维结构显示清晰、PFO-RLS检出率高的特点,能够满足临床需要,是目前诊断PFO及分流量较为理想的方式。
【Objective】To investigate the application of dexmedetomidine combined with sufentanil anesthesia in the diagnosis of patent foramen ovale(PFO)by contrast-transesophageal echocardiograohy(c-TEE).【Methods】A total of 194 patients with right-left shunt(RLS)admitted to our hospital for migraine or suspected stroke of unknown cause and initially screened by contrast-transthoracic echocardiography(c-TTE)were selected.General data of the patients were collected.Fifty patients received traditional painless propofol anesthesia in the early stage(propofol group)and dexmedetomidine+sufentanil anesthesia in the later stage(modified group).Intubation response(BP,HR,SpO_(2),etc.)and adverse reactions were compared between the two groups.At the same time,the diagnostic efficacy of TEE for patent foramen ovale(PFO)under two anesthesia schemes was compared,including the clear display of two-dimensional structure,the detection of right-to-left shunt and quantitative diagnosis.【Results】The incidence of intubation reaction and adverse reactions(such as drowsiness and dizziness)in the modified group was lower than that in the propofol group(P<0.05),but there were no significant differences in HR,BP and SpO_(2) before and after intubation in each group.There was a significant difference in anatomical risk factors between the two groups(χ^(2)=18.85,P<0.001),but there was no significant difference in the clarity of two-layer structure between the two groups(χ^(2)=1.12,P=0.291).There was significant difference in the detection rate of PFO-RLS in c-TEE diagnosis between the two groups(χ^(2)=16.20,P<0.001),and the improved group was higher than the propofol group.There was significant difference in the detection rate of PFO-RLS in c-TTE diagnosis between the propofol group and c-TEE diagnosis between the propofol group(χ^(2)=9.89,P<0.001).There was no significant difference in the modified group(χ^(2)=3.03,P=0.082).【Conclusion】c-TEE under dexmedetomidine combined with sufentanil anesthesia has the characteristics of few
作者
王雪
胡培
肖彬
赵祥
郑光美
WANG Xue;HU Pei;XIAO Bin;ZHAO Xiang;ZHENG Guangmei(Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Department of Ultrasound,Shiyan People's Hospital Affiliated to Hubei University of Medicine,Shiyan,Hubei 442000,China)
出处
《中国医学工程》
2023年第3期8-13,共6页
China Medical Engineering
基金
湖北省十堰市科技局引导性科研项目(21Y55,19Y80)。
关键词
右美托咪定
舒芬太尼
经食道超声心动图
右心声学造影
右向左分流
卵圆孔未闭
dexmedetomidine
sufentanil
transesophageal echocardiography
radiography of right aspiration
right-to-left shunt
patent foramen ovale
