DEX结合纳布啡对腹腔镜胆囊切除术患者全麻苏醒期血流动力学指标的影响.pdf
《DEX结合纳布啡对腹腔镜胆囊切除术患者全麻苏醒期血流动力学指标的影响.pdf》由会员分享,可在线阅读,更多相关《DEX结合纳布啡对腹腔镜胆囊切除术患者全麻苏醒期血流动力学指标的影响.pdf(5页珍藏版)》请在文库网上搜索。
1、中外医疗China&Foreign Medical Treatment2023 NO.21中外医疗 China&Foreign Medical Treatment论著论著DEX结合纳布啡对腹腔镜胆囊切除术患者全麻苏醒期血流动力学指标的影响张刚1,潘巧娟21.山东颐养健康集团淄博医院麻醉科,山东淄博 255120;2.淄川区医院心血管内科,山东淄博 255199摘要 目的 探究对腹腔镜胆囊切除术患者给予右美托咪定(dexmedetomidine,DEX)+纳布啡麻醉方式对其苏醒期血流动力学指标的影响。方法 方便选择 2020年 1月2023年 1月山东颐养健康集团淄博医院的腹腔镜胆囊切除术患者9
2、8例,利用双盲法等比例分为对照组和观察组,各49例,对照组给予DEX麻醉,观察组在对照组基础上给予盐酸纳布啡注射液,对比两组血流动力学、神经系统抑制机体免疫功能、手术指标与麻醉效果、术后不同时间点镇痛效果、不良事件发生率。结果 麻醉后苏醒期,观察组各项血流动力学指标均高于对照组,差异有统计学意义(P0.05)。手术开始8 min后观察组各项神经系统抑制机体免疫功能指标均高于对照组,差异有统计学意义(P0.05)。观察组各项手术指标与麻醉效果评分均低于对照组,差异有统计学意义(P0.05)。观察组术后不同时间点镇痛效果评分均低于对照组,差异有统计学意义(P0.05)。术后观察组不良事件总发生率低
3、于对照组(6.12%vs 20.41%),差异有统计学意义(2=4.346,P0.05)。结论 对腹腔镜胆囊切除术患者给予DEX+纳布啡麻醉方式可稳定患者血流动力学指标,降低手术应激和苏醒后躁动,镇痛效果更佳,总体不良事件发生率更低。关键词 腹腔镜胆囊切除术;纳布啡;右美托咪定;血流动力学中图分类号 R614 文献标识码 A 文章编号 1674-0742(2023)07(c)-0040-05Effect of DEX Combined with Nalbuphine on Hemodynamic Indexes in Laparoscopic Cholecystectomy Patients
4、after Recovery under General AnesthesiaZHANG Gang1,PAN Qiaojuan21.Department of Anesthesiology,Shandong Yiyang Health Group Zibo Hospital,Zibo,Shandong Province,255120 China;2.Department of Cardiovascular Medicine,Zichuan District Hospital,Zibo,Shandong Province,255199 ChinaAbstract Objective To exp
5、lore the effect of dexmedetomidine(DEX)+nalbuphine anesthesia on hemodynamic indexes in patients undergoing laparoscopic cholecystectomy.Methods 98 patients with laparoscopic cholecystectomy in Shandong Nursing and Health Group Zibo Hospital from January 2020 to January 2023 were conveniently select
6、ed and divided into control group and observation group by double-blind method,49 cases in each group.The control group was given DEX anesthesia,and the observation group was given nbuphine hydrochloride injection on the basis of the control group.The hemodynamics,nervous system suppression of immun
7、e function,surgical indexes and anesthesia effect,postoperative analgesia effect at different time points,and incidence of adverse events were compared between the two groups.Results In the recovery period after anesthesia,the hemodynamic indexes in the observation group were higher than those in th
8、e control group,and the difference was statistically significant(P0.05).8 min after operation,the indexes of nervous system suppression of immune function in the observation group were higher than those in the control group,and the difference was statistically significant(P0.05).The surgical indexes
9、 and anesthetic effect scores of the observation group were lower than those of the control group,and the difference was statistically significant(P0.05).The analgesic effect scores of the observation group were lower than those of the control DOI:10.16662/ki.1674-0742.2023.21.040作者简介 张刚(1981-),男,本科
10、,副主任医师,主要从事麻醉科工作。402023 NO.21中外医疗China&Foreign Medical TreatmentChina&Foreign Medical Treatment 中外医疗论著论著group at different time points,and the difference was statistically significant(P0.05).The total incidence of adverse events in the observation group was lower than that in the control group(6.12%
11、vs 20.41%),and the difference was statistically significant(2=4.346,P0.05),具有可比性。本研究通过医院伦理委员会批准。1.2 纳入与排除标准纳入标准:患者具备有症状和有手术指征的胆囊隆起性疾病;患者及家属签署知情同意书;无手术及麻醉禁忌证患者;美国麻醉学医师协会(American Society of Anesthesiologists,ASA)评级级患者。排除标准:妊娠期或哺乳期患者;有心肺肝肾等重要系统疾病患者;基本资料不全患者;严重血流动力学紊乱患者。1.3 方法对照组:给予 DEX 麻醉,为患者注射盐酸右美托咪定
12、注射液国药准字 H20110085,规格:2 mL 0.2 mg(以右美托咪定计),用 0.9%氯化钠溶液稀释,使得稀释浓度达到 40 g/mL,在气管插管中缓慢注入,恒速静脉泵注,按照0.75 g/kg剂量注入以维持麻醉,若手术期间患者心率4分)表示。术后不同时间点镇痛效果主要监测患者术后2、6、12、24 h 痛觉视觉模拟评分量表(Visual Analogue Scale/Score,VAS)评分,010 分表示无痛剧烈疼痛,分数与患者疼痛程度成正比。不良事件发生率主要评估患者术后恶心呕吐、血压异常、窦性心动过速、呛咳发生率,总发生率=发生例数/总例数100%。1.5 统计方法采用 SP
13、SS 25.0 统计学软件分析数据。符合正态分布的计量资料以(x s)表示,行 t 检验,计数资料以例(n)和率表示,行 2检验,P0.05);手术开始8 min,观察组患者MAP、CI、HR、DBP、SBP均高于对照组,差异有统计学意义(P0.05);手术开始 8 min,观察组 IL-4、IFN-均高于对照组,差异有统计学意义(P0.05),见表2。2.3 两组患者手术指标与麻醉效果对比观察组患者手术时间、麻醉起效时间、苏醒时间、气管拔管时间、苏醒后恢复时间、SAS评分均低于对照组,差异有统计学意义(P0.05),见表3。2.4 两组患者术后不同时间点镇痛效果对比观察组患者术后2、6、12
14、、24 h VAS评分均低于对照组,差异有统计学意义(P0.05),见表4。表3两组患者手术指标与麻醉效果比较(x s)指标手术时间(min)麻醉起效时间(min)苏醒时间(min)气管拔管时间(min)苏醒后恢复时间(min)苏醒后躁动情况(分)对照组(n=49)59.3710.043.251.0772.455.2820.355.2011.320.663.660.52观察组(n=49)48.548.302.880.6260.373.2718.274.359.351.243.070.31t值5.8202.09413.6152.1489.8176.822P值0.0010.0390.0010.03
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- DEX 结合 纳布啡 腹腔镜 胆囊 切除 患者 全麻 苏醒 血流 动力学 指标 影响