| 童博,杨宗林,李瑞,等.右美托咪啶对老年高血压患者手术中应激反应和循环功能的影响[J].安徽医药,2018,22(7):1369-1372. |
| 右美托咪啶对老年高血压患者手术中应激反应和循环功能的影响 |
| Effects of dexmedetomidine on stress response and circulation in elderly patients with hypertension |
| 投稿时间：2017-06-17 |
| DOI： |
| 中文关键词: 右美托咪啶 腹腔镜检查 高血压 应激, 生理学 老年人 |
| 英文关键词: Dexmedetomidine Laparoscopy Hypertension Stress, physiological Aged |
| 基金项目:陕西省教育厅专项科研计划项目(11JK0726) |
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| 中文摘要: |
| 目的 观察右美托咪啶(DEX)对老年高血压患者腹腔镜手术中应激反应和血流动力学的影响。方法 选取拟行择期腹腔镜下胃癌根治术老年高血压40例,年龄(74.4±7.8)岁, ASA分级为Ⅱ～Ⅲ级,采用随机数字表法分成DEX组(D组)和生理盐水组(S组)。记录患者术中平均动脉压(MPA)和心率(HR),及拔管时呛咳、躁动例数、拔管时间、意识恢复时间,并测定静脉血肾上腺素(E)和去甲肾上腺素(NE)含量。结果 与T0(入室后10 min)相比,D组MAP、E、NE无显著变化(P＞0.05),HR在T5(解除气暖后5 min)、T6(拔管后即刻)[(63.4±7.2)次/分钟;(64.1±7.3)次/分钟]显著降低(P＜0.05),S组T2(插管时)、T3(气腹建立后5 min)时MAP[(139.7±12.1) mmHg、 (141.4±11.7) mmHg]、HR[(86.7±10.8)次/分钟、(87.4±11.2)次/分钟)]显著升高(P＜0.05),T2、T6时E[(135.6±23.4)、(125.7±19.2) μg·L-1]和NE[(435.5±92.7)、(457.3±94.6) μg·L-1]显著升高(P＜0.05)；S组T2、T3、T6时的MAP[(139.7±12.1),(141.4±11.7),(122.5±11.3) mmHg]和HR[(86.7±10.8)、(87.4±11.2)、(77.5±8.7)次/分钟]及T2、T6时的E[(135.6±23.4)、(125.7±19.2) μg·L-1]、NE[(435.5±92.7)、(457.3±94.6) μg·L-1]均较D组显著升高(P＜0.05)。结论 DEX用于老年高血压患者腹腔镜手术中能够维持循环功能稳定,有效抑制应激反应,并能降低拔管时的相关并发症,提高麻醉安全性。 |
| 英文摘要: |
| Objective To observe the effect of Dexmedetomidine (DEX) on stress response and hemodynamics in elderly patients with hypertension undergoing laparoscopic surgery. Methods 40 elderly patients with hypertension undergoing laparoscopic radical gastrectomy with average age (74.4±7.8) and ASA Ⅱ-Ⅲ level were selected, which were randomly divided into DEX group (group D) and normal saline group (S). The average arterial pressure and heart rate and the cough, the number of restless cases, the time of extubation and the recovery time of consciousness, also measure the content of Epinephrine (E) and Norepinephrine (NE) in venous blood of this patients were recorded. Results Compared with T0, there was no significant change in MAP, NE, HR in group D (P>0.05). HR(63.4±7.2、 64.1±7.3min-1) decreased significantly at T5 and T6 (P＜0.05). In group S, MAP(139.7±12.1; 141.4±11.7 mmHg) and HR (86.7±10.8; 87.4±11.2)were significantly increased at T2 and T3 (P＜0.05), and the content of E(135.6±23.4、125.7±19.2 μg·L-1) and NE(435.5±92.7、457.3±94.6 μg·L-1)increased significantly at T2 and T6 (P＜0.05). Compared with group S, the MAP(139.7±12.1、 141.4±11.7、122.5±11.3 mmHg)and HR(86.7±10.8、 87.4±11.2、 77.5±8.7 min-1))at T2, T3, T6, with the content of E(135.6±23.4、125.7±19.2 μg·L-1) and NE(435.5±92.7、457.3±94.6 μg·L-1)at T2, T6 were significantly higher than those in Dgroup (P＜0.05). Conclusion DEX can maintain the stability of circulation, inhibit the stress response effectively, reduce the complications and improve the safety of the anaesthesia in the elderly patients with hypertension. |
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