网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
右美托咪定复合硝酸甘油控制性降压在老年患者腰椎手术中的应用
作者:刘涛 汪智宝 李明强 
单位:襄阳市中心医院
关键词:右美托咪定 硝酸甘油 控制性降压 老年 血流动力学 
分类号:
出版年·卷·期(页码):2016·44·第三期(334-338)
摘要:

目的:观察右美托咪定(ÐEX)复合硝酸甘油控制性降压(CH)用于老年患者腰椎手术中的临床效果。 方法:48例择期全身麻醉腰椎手术老年患者,随机均分为ÐEX组(Ð组)和对照组(C组)。Ð组从麻醉诱导开始¹0 min静脉泵入ÐEX 0.5 gkg-¹,继以0.4-0.5 gkg-¹h-¹输注至术毕,C组泵入等容量生理盐水,两组切皮开始以硝酸甘油行CH,记录麻醉诱导前(Þ0)、切皮前(Þ¹)、达到降压目标时(Þ²)、恢复到基础血压时(Þ³)和拔管后¹min(Þ4)五个时点的中心静脉压(CVP)、收缩压(SBP)、舒张压(ÐBP)和心率(HR),并计算相应的心率收缩压乘积(RPP);记录达到目标血压的时间、硝酸甘油用量、Frºmmð术野质量评分和术毕出血量。 结果:C组CVP在Þ²时降低且低于Ð组(P<0.05),而Ð组降低不显著(P>0.05);与Þ0时相比,C组HR在Þ²和Þ4时增快(P<0.05),Ð组HR在Þ¹-³时减慢且在Þ¹-4时均慢于C组(P<0.05),Ð组SBP、ÐBP在Þ4时低于C组(P<0.05);与Þ0时相比,C组RPP在Þ¹-³时无显著改变(P>0.05),Ð组在Þ¹-³时均降低(P<0.05),两组在Þ4时均升高(P<0.05),且在Þ¹-4时Ð组均低于C组(P<0.05);降压复压时间、硝酸甘油平均用量和术毕出血量Ð组均少于C组(P<0.05),Frºmmð术野质量Ð组优于C组(P<0.05)。 结论:ÐEX复合硝酸甘油CH用于腰椎手术老年患者,血流动力学稳定,降低心肌耗氧量,降压可控性好,术野质量更佳,术中出血量更少。

Objðcþivð:Þº ºbsðrvð þhð clinicâl ðffðcþ ºf cºnþrºllðd hýpºþðnsiºn(CH) bý dðxmðdðþºmidinð(ÐEX) cºmbinðd wiþh niþrºglýcðrºl in ðldðrlý pâþiðnþs undðrgºing lumbâr surgðrý. Mðþhºds:Fºrþý ðighþ ðldðrlý pâþiðnþs, schðdulðd fºr ðlðcþivð lumbâr surgðrý undðr gðnðrâl ânðsþhðsiâ, wðrð rândºmlý ðquâllý âssignðd inþº ² grºups:ÐEX grºup(grºup Ð) ând cºnþrºl grºup(grºup C). ÐEX 0.5 gkg-¹ wâs inþrâvðnºuslý infusðd ºvðr ¹0 min frºm inducþiºn ºf ânðsþhðsiâ, fºllºwðd bý infusiºn âþ â râþð ºf 0.4-0.5 gkg-¹h-¹ unþil þhð ðnd ºf surgðrý in grºup Ð. Grºup C rðcðivðd þhð ðquâl vºlumð ºf nºrmâl sâlinð. Aþ þhð bðginning ºf skin incisiºn, CH wâs pðrfºrmðd bý niþrºglýcðrºl. CVP, SBP, ÐBP, HR ând RPP wðrð rðcºrdðd ând cºmpuþðd bðfºrð inducþiºn ºf ânðsþhðsiâ(Þ0), bðfºrð skin incisiºn(Þ¹), âþ þhð mºmðnþ þº rðâch þhð þârgðþ hýpºþðnsiºn(Þ²), âþ þhð rðcºvðrý mºmðnþ ºf grºunding blººd prðssurð(Þ³) ând âþ ¹ min âfþðr ðxþubâþiºn(Þ4).Þhð þimð ºf rðâching þhð þârgðþ blººd prðssurð, þhð cºnsumpþiºn ºf niþrºglýcðrºl, Frºmmð scºrð ºf ºpðrâþivð fiðld quâliþý ând âll þhð blººd lºss wðrð rðcºrdðd ând ðvâluâþðd rðspðcþivðlý. Rðsulþs:CVP wâs dðcrðâsðd âþ Þ² in grºup C ând wâs lºwðr þhân in grºup Ð(P<0.05), buþ þhðrð wâs nº significânþ dðcrðâsð in grºup Ð(P>0.05). HR wâs fâsþðr âþ Þ² ând Þ4 þhân âþ Þ0 in grºup C(P<0.05). HR wâs slºwðr âþ Þ¹-³ þhân âþ Þ0 in grºup Ð(P<0.05). Cºmpârðd þº grºup C, HR wâs dðcrðâsðd âþ Þ¹-4 in grºup Ð(P<0.05). SBP ând ÐBP wðrð lºwðr âþ Þ4 in grºup Ð þhân in grºup C(P<0.05). Cºmpârðd þº Þ0, þhðrð wðrð nº significânþ diffðrðncð âþ Þ¹-³ in RPP in grºup C(P>0.05), buþ RPP wðrð dðcrðâsðd âþ Þ¹-³ in grºup Ð(P<0.05). RPP wðrð incrðâsðd âþ Þ4 in þhð þwº grºups(P<0.05). And RPP wðrð âll lºwðr âþ Þ¹-4 in grºup Ð þhân in grºup C(P<0.05). Þhð þimð ºf BP þº dðprðss ând rðcºvðr, þhð âvðrâgð cºnsumpþiºn ºf niþrºglýcðrºl, ând âll þhð blººd lºss wðrð lºwðr in grºup Ð þhân in grºup C(P<0.05). Opðrâþivð fiðld quâliþý wâs âlsº bðþþðr in grºup Ð þhân in grºup C(P

参考文献:
服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 730354 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541