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| 右美托咪定对腭咽成形术患者围术期应激反应的影响 |
| Effects of dexmedetomidine on the perioperative stress in patients undergoing uvulopalatopharyngoplasty |
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| DOI： |
| 中文关键词: 右美托咪定 腭咽成形术 应激反应 |
| 英文关键词: Dexmedetomidine Uvulopalatopharyngoplasty Stress reaction |
| 基金项目: |
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| 摘要点击次数: 3141 |
| 全文下载次数: 1974 |
| 中文摘要: |
目的 观察右美托咪定对腭咽成形术(uvulopalatopharyngoplasty,UPPP)患者围术期应激反应的影响。
方法 选择择期行腭咽成形术的男性患者60例,年龄18～65岁,ASA Ⅰ或Ⅱ级,随机分为右美托咪定组（D组）和对照组（C组）,每组30例。D组气管插管前先予负荷剂量右美托咪定 1.0 μg/kg 10 min,术中及入ICU后持续静脉泵注右美托咪定 0.5 μg·kg-1·h-1;C组持续泵入等容量生理盐水。记录入室(T0)、气管插管成功即刻(T1)、手术开始30 min(T2)、入ICU即刻(T3)、拔除气管导管即刻(T4)的MAP、HR;检测T0～T4时动脉血PaO2、PaCO2及去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)、IL-6、TNF-α的浓度;记录入ICU后苏醒时间、拔管时间、ICU停留时间及呛咳反应的发生情况。
结果 T1～T4时D组HR 明显慢于C组,MAP明显低于C组(P<0.05);T1～T4时D组NE、E、Cor、IL-6、TNF-α浓度明显低于C组(P<0.05);D组拔管期呛咳发生率为9例（30%），明显低于C组的21例（70％）（P<0.05）。两组苏醒时间、拔管时间及ICU 停留时间差异无统计学意义。
结论 围术期静脉泵注右美托咪定可有效抑制腭咽成形术患者的应激反应,维持循环稳定,且不延长患者苏醒时间、拔管时间及ICU停留时间。 |
| 英文摘要: |
Objective To observe the effects of dexmedetomidine on the perioperative stress in patients undergoing uvulopalatopharyngoplasty (UPPP).
Methods Sixty patients scheduled for uvulopalatopharyngoplasty (UPPP), all males, aged 18-65 years, of ASA physical status Ⅰ or Ⅱ, were selected randomly. Then the patients were divided into dexmedetomidine group (group D) and control group (group C), 30 patients in each group. The patients of group D were administered 1.0 μg/kg bolus dose of dexmedetomidine over 10 min before tracheal intubation, followed by 0.5 μg·kg-1·h-1 infusion for 12 hours in ICU after surgery. And the patients in group C were given normal saline instead as in group D. The levels of MAP, HR, PaO2, PaCO2, norepinephrine (NE), epinephrine (E), cortisol (Cor), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were recorded at time points of entering operating room (T0), tracheal intubation (T1), 30 min after operation (T2), upon entering ICU (T3), and extubation (T4).
Results HR of group D was significantly slower than that of group C during T1-T4 (P<0.05). MAP of group D was lower than that of group C during T1-T4 (P<0.05). The levels of NE, E, Cor, IL-6, TNF-α of group D were significantly lower than that of group C during T1-T4(P<0.05). Compared with group C [21(70％)], the incidence of cough reflex during extubation was lower in group D significantly [9(30%)] (P<0.05).
Conclusion Intravenous infusion of dexmedetomidine can suppress perioperative stress effectively and stabilize hemodynamics for the patients undergoing UPPP without prolonging the recovering time, extubation time and the duration in ICU. |
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