瑞芬太尼与右美托咪定复合全麻在输尿管软镜碎石术治疗上尿路结石中的应用效果

Application effect of remifentanil and dexmedetomidine combined with general anesthesia in the treatment of upper urinary tract calculi with flexible ureteroscopic lithotripsy

下载PDF

导出

摘要目的研究瑞芬太尼与右美托咪定复合全麻在输尿管软镜碎石术治疗上尿路结石中的应用效果。方法采用随机数字表法将我院行输尿管软镜碎石术治疗的80例上尿路结石患者分为瑞芬太尼组(RF组)40例和瑞芬太尼与右美托咪定组(RF+YM组)40例,两组采用相同的麻醉诱导方案,在麻醉维持上RF组单纯应用瑞芬太尼,RF+YM组应用瑞芬太尼+右美托咪定。于入室时(T_(0))、气管插管时(T_(1))、手术开始30 min(T_(2))、拔管时(T_(3))各时刻点,分别对两组平均动脉压(MAP)、心率(HR)、血氧饱和度(SaO_(2))指标进行检测;于术前及手术开始30 min后,检测血乳酸、血糖、pH值;于术前及术后2 h,检测血清氧化应激反应指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]。结果在组内比较中,RF组T_(1)、T_(2)、T_(3)的MAP、HR均较T_(0)升高(P<0.05),T_(1)、T_(2)、T_(3)的SaO_(2)较T_(0)下降(P<0.05);RF+YM组T_(1)、T_(3)的MAP、HR均较T_(0)升高(P<0.05),T_(1)、T_(2)、T_(3)的SaO_(2)较T_(0)下降(P<0.05)。在组间比较中,RF组T_(2)、T_(3)的MAP、HR均高于RF+YM组(P<0.05),T_(3)的SaO_(2)低于RF+YM组(P<0.05)。手术开始30 min后,RF+YM组血乳酸、血糖均低于RF组,pH值高于RF组(P<0.05)。术后2 h,RF+YM组血清SOD高于RF组,血清MDA低于RF组(P<0.05)。结论在上尿路结石患者行输尿管软镜碎石术治疗中,瑞芬太尼与右美托咪定复合全麻可更好地维持患者血流动力学的稳定,减轻氧化应激损伤,维持患者机体内环境的稳态,降低手术风险。 Objective To study the application effect of remifentanil and dexmedetomidine combined with general anesthesia in the treatment of upper urinary tract calculi with flexible ureteroscopic lithotripsy.Methods A total of 80 patients with upper urinary tract calculi who underwent flexible ureteroscopic lithotripsy in our hospital were divided into remifentanil group(RF group,n=40)and remifentanil and dexmedetomidine group(RF+YM group,n=40)by random number table method.The same anesthesia induction regimen was used in the two groups.In the maintenance of anesthesia,the RF group solely used remifentanil,while the RF+YM group used a combination of remifentanil and dexmedetomidine.The mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SaO_(2))of the two groups were detected at the time of entering the room(T_(0)),tracheal intubation(T_(1)),30 minutes after the beginning of the operation(T_(2))and extubation(T_(3)).Blood lactic acid,blood glucose and pH value were detected before operation and 30 minutes after operation.Serum oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]were detected before and 2 h after operation.Results In the intragroup comparison,MAP and HR at T_(1),T_(2) and T_(3) in the RF group were higher than those at T_(0)(P<0.05),and SaO_(2) at T_(1),T_(2) and T_(3) was lower than that at T_(0)(P<0.05).In RF+YM group,MAP and HR at T_(1) and T_(3) were higher than those at T_(0)(P<0.05),and SaO_(2) at T_(1),T_(2) and T_(3) were lower than that at T_(0)(P<0.05).In the comparison between groups,the MAP and HR of RF group at T_(2) and T_(3) were higher than those of RF+YM group(P<0.05),and the SaO_(2) of T_(3) was lower than that of RF+YM group(P<0.05).At 30 minutes after the beginning of the operation,the blood lactic acid and blood glucose in the RF+YM group were lower than those in the RF group,and the pH value was higher than that in the RF group(P<0.05).At 2 h after operation,serum SOD in RF+YM group was higher than that in RF group,and serum MDA was lower than tha

作者梁国才 LIANG Guo-cai(Department of Anesthesiology,The Second People's Hospital of Xinxing County,Yunfu 527422,China)

机构地区新兴县第二人民医院麻醉科

出处《医师在线》 2024年第10期28-31,共4页 Journal of Doctors Online

关键词输尿管软镜碎石术复合麻醉瑞芬太尼右美托咪定内环境氧化应激 Flexible ureteroscopic lithotripsy Combined anesthesia Remifentanil Dexmedetomidine Internal environment Oxidative stress

分类号 R614 [医药卫生—麻醉学]