摘要
目的探讨右美托咪定对老年腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者血流动力学的影响。方法方便选取2019年1月-2020年12月期间于厦门大学附属第一医院行LC手术治疗的102例老年胆囊疾病患者为研究对象,以随机数表将其分为两组,各51例。对照组直接进行麻醉诱导,研究组麻醉诱导前使用右美托咪定。比较两组手术时间、苏醒时间、丙泊酚用量,气管插管时(T1)、切皮时(T2)、胆囊切除时(T3)、手术结束时(T4)的平均动脉压(MAP)与心率(HR)指标,以及麻醉相关不良反应情况。结果研究组手术时间(48.22±4.03)min与术后苏醒时间(15.02±4.98)min与对照组(47.98±4.90)、(15.40±5.11)min对比,差异无统计学意义(t=0.270、0.380,P>0.05)。研究组丙泊酚用量(300.52±35.03)mg低于对照组(368.52±40.05)mg,差异有统计学意义(t=9.127,P<0.001)。研究组T3、T4时间点时MAP与HR水平较对照组更低,差异有统计学意义(t=7.909、6.074、7.949、7.439,P<0.001)。研究组麻醉相关不良反应发生率3.92%低于对照组17.64%,差异有统计学意义(χ^(2)=4.993,P<0.05)。结论右美托咪定能够有效维持老年LC手术患者的血流动力学稳定性,安全可靠,适于临床推广。
Objective To investigate the effect of dexmedetomidine on hemodynamics in elderly patients undergoing laparoscopic cholecystectomy(LC).Methods 102 elderly patients with gallbladder disease who underwent LC surgery in the First Hospital of Xiamen University from January 2019 to December 2020 were conveniently selected as the study objects.They were divided into two groups of by a random number table,51 cases each.Anesthesia was directly induced in the control group and dexmedetomidine was used before induction of anesthesia in the study group.The surgical time,awakening time,propofol dosage,mean arterial pressure(MAP)and heart rate(HR)indexes at the time of tracheal intubation(T1),skin removal(T2),gallbladder removal(T3),and end of surgery(T4),and anesthesiarelated adverse effects were compared between the two groups.Results The surgical time and postoperatire awakening time between the study group[(48.22±4.03)min,(15.02±4.98)min]and control group[(47.98±4.90)min,(15.40±5.11)min]were compared,the difference was not statistically significant(t=0.270,0.380,P>0.05).The propofol dosage in the study group(300.52±35.03)mg was lower than(368.52±40.05)mg in the control group,and the difference was statistically significant(t=9.127,P<0.001).The levels of MAP and HR in the study group at T3 and T4 time points were lower than those in the control group,and the difference was statistically significant(t=7.909,6.074,7.949,7.439,P<0.001).The incidence of anesthesia-related adverse reactions in the study group was 3.92%,lower than 17.64%in the control group,and the difference was statistically significant(χ^(2)=4.993,P<0.05).Conclusion Dexmedetomidine can effectively maintain the hemodynamic stability of elderly LC surgery patients,is safe and reliable,and is suitable for clinical promotion.
作者
陈小妹
CHEN Xiaomei(Department of Anesthesiology,the First Hospital of Xiamen University,Xiamen,Fujian Province,361006 China)
出处
《中外医疗》
2022年第33期123-126,131,共5页
China & Foreign Medical Treatment
作者简介
陈小妹(1988-),女,本科,副主任医师,研究方向为麻醉药理学。
