右美托咪定改善全麻苏醒期患者血液动力学及医院感染的疗效观察(1)
摘 要：目的 分析右美托咪定对全麻苏醒期血液动力学及医院感染的改善效果。方法 选取2016年9月～2017年9月我院收治的86例接受腹腔手术的胆结石患者为研究对象，依据随机数字表法分为观察组和对照组，各43例。对照组患者均接受本院传统的全麻诱导及腹腔手术治疗，观察组在对照组的基础上实施全麻诱导+右美托咪定诱导镇静。比较两组患者术后苏醒时间、躁动率、脉搏指标水平、呼吸道及伤口感染率情况。结果 两组患者手术时间及术后苏醒时间比较，差异无统计学意义(P>0.05)，观察组患者苏醒期躁动发生率低于对照组，差异有统计学意义(P<0.05)；观察组患者苏醒期心率、平均动脉压和脉搏血氧饱和度均优于对照组，差异有统计学意义(P<0.05)；观察组患者苏醒期的医院感染率低于对照组，差异有统计学意义(P<0.05)。结论 全麻诱导前静脉注射右美托咪定可以有效改善患者的血液动力水平，稳定患者情绪降低躁动比例以及减少术后感染率，值得推广应用。
关键词：右美托咪定；全麻苏醒期；脉搏指标；医院感染
, 百拇医药
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.12.039
文章编号：1006-1959(2018)12-0128-03
Abstract：Objective To analyze the effect of dexmedetomidine on hemodynamics and nosocomial infection during the resuscitation period of general anesthesia.Methods 86 patients with gallstones who underwent abdominal surgery from September 2016 to September 2017 in our hospital were selected as study subjects.According to the random number table method，they were divided into observation group and control group，43 cases each.The patients in the control group received conventional anesthesia induction and abdominal surgery.The observation group was induced by induction of general anesthesia plus dexmedetomidine on the basis of the control group.The time of awakeness，agitation rate，pulse index level，respiratory tract and wound infection rate were compared between the two groups.Results There was no significant difference in operative time and postoperative recovery time between the two groups (P>0.05).The incidence of agitation in the observation period was lower in the observation group than in the control group，the difference was statistically significant(P<0.05).The heart rate，mean arterial pressure，and pulse oxygen saturation in the observation group were better than those in the control group，the difference was statistically significant(P<0.05)；The rate of nosocomial infection in the observation period was lower in the observation group than in the control group，the difference was statistically significant(P<0.05). Conclusion Intravenous injection of dexmedetomidine before induction of general anesthesia can effectively improve the hemodynamic level of patients，stabilize the patient's mood，reduce the rate of agitation and reduce the postoperative infection rate.It is worth popularizing and applying.
, http://www.100md.com
Key words：Dexmedetomidine；General anesthesia recovery period；Pulse index；Nosocomial infection
膽结石又称胆石症(cholelithiasis)，是指胆道系统包括胆囊或胆管内发生结石的疾病，目前关于胆结石的治疗方式主要包括微波碎石技术和腹腔镜胆囊切除术，腹腔镜胆囊切除术是治疗胆结石最为有效的根除疗法，但是这种开腹术需要深度麻醉以提高手术效果，然而这种深度麻醉具有影响患者血流动力学及造成术后并发症的风险。为了有效降低术后风险的发生，近年来国内有大量使用右美托咪定诱导前麻醉稳定术中血流动力学的报道[1]。右美托咪定是α2肾上腺素能受体的激动剂，在全麻前使用可以有效降低全麻药的用量，有效降低全麻药大量导致的副作用，同时其镇痛作用可以减少伤口二次损失及感染[2]。为有效证实右美托咪定在腹腔胆囊切除术中改善全麻苏醒期患者血液动力学水平及术后感染率的作用，本研究以2016年9月～2017年9月我院收治的86例接受腹腔手术的胆结石患者为研究对象，进行对比验证效果显著，现报道如下。, 百拇医药(周刚)
关键词：右美托咪定；全麻苏醒期；脉搏指标；医院感染
, 百拇医药
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.12.039
文章编号：1006-1959(2018)12-0128-03
Abstract：Objective To analyze the effect of dexmedetomidine on hemodynamics and nosocomial infection during the resuscitation period of general anesthesia.Methods 86 patients with gallstones who underwent abdominal surgery from September 2016 to September 2017 in our hospital were selected as study subjects.According to the random number table method，they were divided into observation group and control group，43 cases each.The patients in the control group received conventional anesthesia induction and abdominal surgery.The observation group was induced by induction of general anesthesia plus dexmedetomidine on the basis of the control group.The time of awakeness，agitation rate，pulse index level，respiratory tract and wound infection rate were compared between the two groups.Results There was no significant difference in operative time and postoperative recovery time between the two groups (P>0.05).The incidence of agitation in the observation period was lower in the observation group than in the control group，the difference was statistically significant(P<0.05).The heart rate，mean arterial pressure，and pulse oxygen saturation in the observation group were better than those in the control group，the difference was statistically significant(P<0.05)；The rate of nosocomial infection in the observation period was lower in the observation group than in the control group，the difference was statistically significant(P<0.05). Conclusion Intravenous injection of dexmedetomidine before induction of general anesthesia can effectively improve the hemodynamic level of patients，stabilize the patient's mood，reduce the rate of agitation and reduce the postoperative infection rate.It is worth popularizing and applying.
, http://www.100md.com
Key words：Dexmedetomidine；General anesthesia recovery period；Pulse index；Nosocomial infection
膽结石又称胆石症(cholelithiasis)，是指胆道系统包括胆囊或胆管内发生结石的疾病，目前关于胆结石的治疗方式主要包括微波碎石技术和腹腔镜胆囊切除术，腹腔镜胆囊切除术是治疗胆结石最为有效的根除疗法，但是这种开腹术需要深度麻醉以提高手术效果，然而这种深度麻醉具有影响患者血流动力学及造成术后并发症的风险。为了有效降低术后风险的发生，近年来国内有大量使用右美托咪定诱导前麻醉稳定术中血流动力学的报道[1]。右美托咪定是α2肾上腺素能受体的激动剂，在全麻前使用可以有效降低全麻药的用量，有效降低全麻药大量导致的副作用，同时其镇痛作用可以减少伤口二次损失及感染[2]。为有效证实右美托咪定在腹腔胆囊切除术中改善全麻苏醒期患者血液动力学水平及术后感染率的作用，本研究以2016年9月～2017年9月我院收治的86例接受腹腔手术的胆结石患者为研究对象，进行对比验证效果显著，现报道如下。, 百拇医药(周刚)