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右美托咪定对Wilson病继发脾功能亢进患者全身麻醉下脾切除术后躁动的影响
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| 篇名： | 右美托咪定对Wilson病继发脾功能亢进患者全身麻醉下脾切除术后躁动的影响 |
| TITLE： | |
| 摘要： | 目的：观察右美托咪定对Wilson病继发脾功能亢进患者全身麻醉下脾切除术后躁动的影响。 方法：选取某院2016年1－12月的全身麻醉下行脾切除术Wilson病继发脾功能亢进患者60 例，按随机数字表法分为对照组和观察组，各30例。观察组患者麻醉诱导前15 min静脉恒速泵注右美托咪定 0.4 μg/kg， 之后为0.4 μg/（kg·h）维持至脾切除后；对照组患者给予等量的生理盐水，其余麻醉方案两组相同。观察两组患者开始泵注前（T0）、插管前（T1）、插管后1 min（T2）、拔管前（T3）及拔管后3 min（T4）的平均动脉压（MAP）、心率（HR）和血氧饱和度（SpO2），记录两组患者T3 和T4时间点Riker镇静-躁动评分（SAS），比较两组患者麻醉后监测治疗室（PACU）停留时间及心动过缓发生情况。结果：T0时，两组患者MAP、HR、SpO2水平比较，差异无统计学意义（P＞0.05）；T1、T2、T3、T4时，两组患者MAP、HR水平均显著降低，且观察组显著低于对照组，差异均有统计学意义（P＜0.05）；但SpO2所有时间点均为100％，组间比较，差异无统计学意义（P＞0.05）。观察组患者T3、T4时Riker SAS评分均显著低于对照组，差异均有统计学意义（P＜0.05）。观察组患者心动过缓发生率为26.67％，显著高于对照组的3.33％，差异有统计学意义（P＜0.05），但静脉注射阿托品后均得以纠正。观察组PACU停留时间显著短于对照组，差异有统计学意义（P＜0.05）。结论：右美托咪定能稳定Wilson病继发脾功能亢进患者术后血流动力学，降低躁动情况，并缩短PACU转出时间。 |
| ABSTRACT： | OBJECTIVE： To observe the effects of dexmedetomidine （Dex） on postoperative agitation of Wilson’s disease patients with secondary hypersplenism after genernl anesthesia of splenectomy. METHODS： A total of 60 Wilson’s disease patients with secondary hypersplenism underwent general anesthesia of splenectomy duning Jan.-Dec. 2016 were divided into control group and observation group according to random number table， with 30 cases in each group. Observation group was given intravenous pump of Dex 0.4 μg/kg at constant speed 15 min before anesthesia induction， and then maintained at 0.4 μg/（kg·h）till splenectomy completed. Control group was given constant volume of normal saline. Other anesthesia plans were same in 2 groups. Mean arterial pressure （MAP）， heart rate （HR） and pulse oxygen saturation （SpO2） of 2 groups were observed before pumping （T0）， before intubation （T1）， 1 min after intubation （T2）， before extubation （T3）， 3 min after extubation （T4）. Riker sedation-agitation score （SAS） were recorded in 2 groups at T3 and T4. The duration of stay in postanesthesia intensive care unit （PACU） and the occurrence of bradycardia were compared between 2 groups. RESULTS： At T0， there was no statistical significance in MAP， HR or SpO2 levels between 2 groups （P＞0.05）. At T1， T2， T3 and T4， MAP and HR levels of 2 groups were decreased significantly， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. SpO2 were 100％ at each time point， there was no statistical significance between 2 groups （P＞0.05）. Riker SAS scores of observation group was significantly lower than that of control group， with statistical significance （P＜0.05）. The incidence of bradycardia in observation group was 26.67％， which was significantly higher than 3.33％ of control group， with statistical significance （P＜0.05）. But this symptom was corrected after intravenous injection of atropine. The duration of stay in PACU in observation group was significantly shorter than control group， with statistical significance （P＜0.05）. CONCLUSIONS： Dex can keep postoperative hemodynamics stable in Wilson’s disease patients with secondary hypersplenism， reduce agitation and shorten the time of the patients transferring from PACU. |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 张永志，张野，张丁，季淼 |
| AUTHORS： | ZHANG Yongzhi，ZHANG Ye，ZHANG Ding，JI Miao |
| 关键字： | 右美托咪定；术后躁动；Wilson病；脾切除；全身麻醉 |
| KEYWORDS： | Dexmedetomidine； Postoperative agitation； Wilson’s disease； Splenectomy； General anesthesia |
| 阅读数： | 236 次 |
| 本月下载数： | 2 次 |
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