摘要
目的分析研究右旋美托咪定在碘缺乏型甲状腺肿大所致困难气道气管插管中的应用效果,为碘缺乏型甲状腺肿大所致困难气道患者的治疗提供新的麻醉方式及理论支持。方法 66例碘缺乏型甲状腺肿大所致困难气道患者,随机分为观察组与对照组,各33例。对照组静脉注射咪唑安定及芬太尼,观察组持续泵入右旋美托咪定,放入气管导管后静脉输注芬太尼、丙泊酚、顺阿曲库铵,并连接麻醉机进行机械通气。对比观察两组患者麻醉前后SBP、DBP、HR、SpO_2、BIS、警觉/镇静评分变化情况、不良反应发生率及插管时患者的反应和舒适程度、术后随访半年情况。结果麻醉前两组患者SBP、DBP、HR、SpO_2、BIS、警觉/镇静评分比较,差异均无统计学意义(P>0.05);实施麻醉后,观察组SBP及HR水平明显优于对照组,差异有统计学意义(P<0.05);观察组与对照组BIS、OAA/S与麻醉前相比,差异有统计学意义(P<0.05);观察组不良反应发生率为3.03%,对照组为24.24%,比较差异有统计学意义(P<0.05);观察组插管时反应及舒适度评分均明显低于对照组,差异有统计学意义(P<0.05);通过随访得知,观察组中有18.18%(6/33)例患者可模糊记起气管插管操作,而对照组无患者可记起气管插管操作,比较差异有统计学意义(P<0.05)。结论对碘缺乏型甲状腺肿大所致困难气道患者气管插管前静脉注射右旋美托咪定效果显著,血流动力学较为平稳,不良反应发生率低,对患者进行气管插管时刺激性较小,舒适度较高,具有一定安全性和临床价值,值得推广运用。
Objective To analytical investigate the application effect of trachea cannula of difficult airway caused by iodine deficient goiter treated dexmedetomidine,to provide the new anesthesia method and theoretical support for the treatment of trachea cannula of difficult airway caused by iodine deficient goiter.Methods To selected 66 patients with trachea cannula of difficult airway caused by iodine deficient goiter at our hospital from March,2012 to June,2015 for grouping study,to randomly divided into the treatment group and the control group,each 33 cases.The control group was given midazolam and fentanyl by intravenous injection,and the treatment group was continuously-pumped the dexmedetomidine,put into the endotracheal tube and given the fentanyl,propofol,cisatracurium bromide by venoclysis,and connected anaesthesia machine for mechanical ventilation.To compared the changes of grade of SBP,DBP,HR,SpO2,BIS and vigilance/mitigation of two groups that before and after anesthesia,the adverse effects rate,reaction and degree of comfort of the patients during intubation,and the condition of post-operation follow-up for half year.Results To compared the changes of grade of SBP,DBP,HR,SpO2,BIS and vigilance/mitigation of two groups,there was no statistical significance（P>0.05）.After the implementation of anesthesia,the level of SBP and HR of the treatment group was significantly better than the control,there was statistical significance（P<0.05）.To compared the BIS and OAA/S of them with that before anesthesia,there was statistical significance（P<0.05）.The adverse effects rate of the treatment group was 3.03%,the control group was 24.24%,the comparison among groups that was statistical significance（P<0.05）.The reaction and degree of comfort during intubation of the treatment group was significantly lower than control,there was statistical significance（P<0.05）.To learn by the follow-up visit,there was 18.18%（6/33）of patients was fuzzy remembered the operation of trachea cannula,while there was no body was remembered the operation of trachea cannula,the comparison among groups that was statistical significance（P<0.05）.Conclusion That has an significant effect of trachea cannula of difficult airway caused by iodine deficient goiter treated dexmedetomidine,the haemodynamics very smoothly,the adverse effects rate was low,and with small thrill for the trachea cannula of patients,the comfort was higher.That has certainly safety and clinical value,and worth for promotion.
出处
《中国地方病防治》
CAS
北大核心
2016年第4期415-417 473,473,共4页
Chinese Journal of Control of Endemic Diseases
基金
山东省自然科学基金(ZR2011HM057)
