| 李德平,薛 韬,王悦喜,张迎军,李 鹏.右美托咪定联合七氟烷对心脑血管介入患者血液动力学及苏醒影响[J].,2020,(5):914-918 |
| 右美托咪定联合七氟烷对心脑血管介入患者血液动力学及苏醒影响 |
| Effects of Dexmedetomidine Combined with Sevoflurane on Hemodynamics and Recovery in Patients with Cardiovascular and Cerebrovascular Intervention |
| 投稿时间：2019-10-10 修订日期：2019-10-30 |
| DOI：10.13241/j.cnki.pmb.2020.05.025 |
| 中文关键词: 右美托咪定 七氟烷 心脑血管介入治疗 血液动力学 |
| 英文关键词: Dexmedetomidine Sevoflurane Cardiovascular and cerebrovascular interventional therapy Hemodynamics |
| 基金项目:内蒙古自治区自然科学基金项目（2016MS0853） |
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| 中文摘要: |
| 摘要 目的：探究右美托咪定联合七氟烷对心脑血管介入治疗患者血液动力学影响，并分析药物对患者苏醒干预效果。方法：选择2015年3月至2019年3月于我院均接受介入治疗的心脑血管系统疾病92例，按照随机数字表法将其均分为研究组与对照组（各46例），对照组采用七氟烷麻醉并以生理盐水进行连续泵注，研究组采用七氟烷联合右美托咪定的方式实施麻醉，对比两组T0（麻醉诱导前）、T1（气管插管后）、T2（手术结束时）、S1（苏醒即刻）、S2（指令配合）、S3（气管拔除）时的心率（Heart rate，HR）、平均动脉压（Mean arterial pressure，MAP），对比两组苏醒时Riker镇静和躁动评分（Riker sedation and agitation score，SAS）及拔管时间。结果：（1）对比显示，T0时，两组患者HR与MAP对比差异不具有统计学意义（P>0.05），T1及T2时刻研究组HR及MAP均明显低于对照组（P<0.05）；（2）S1时刻两组HR及MAP对比差异不具有统计学意义（P>0.05），S2及S3时刻研究组HR及MAP均明显低于对照组（P<0.05）；（3）研究组苏醒时其SAS评分低于对照组，拔管时间短于对照组（P<0.05）；（4）观察组随访期间心脑血管事件的发生率为10.87%，显著低于对照组的28.26%（P<0.05）。同时，两组随访期间各死亡1例。结论：心脑血管疾病行介入治疗患者应用右美托咪定联合七氟烷干预能够显著稳定患者血液动力学，同时还能够改善患者苏醒状态，缓解患者随麻醉作用减弱而出现的应激反应，减少心脑血管事件的发生，改善预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of dexmedetomidine combined with sevoflurane on hemodynamics in patients undergoing cardiovascular and cerebrovascular intervention, and to analyze the effect of drugs on patients' wake-up intervention. Methods: 92 patients who with cardiovascular and cerebrovascular diseases underwent interventional therapy in our hospital from March 2015 to March 2019 were randomly divided into study group and control group (46 cases in each group), ccording to the random number table method. Patients in the control group were anesthetized with sevoflurane and continuously pumped with normal saline. Patients in the study group were treated with sevoflurane combined with dexmedetomidine. The heart rate Heart rate (HR) and Mean arterial pressure (MAP) of T0, T1, T2, S1, S2, and S3 were compared between the two groups. Riker sedation and agitation score (SAS) and extubation time were compared between the two groups. Results: (1) The comparison showed that there was no significant difference in HR and MAP between the two groups at T0 (P>0.05). The HR and MAP of the study group at T1 and T2 were significantly lower than those of the control group (P<0.05).(2) There was no significant difference in HR and MAP between the two groups at S1 (P>0.05). The HR and MAP of the study group at S2 and S3 were significantly lower than those of the control group (P<0.05). (3) The SAS score of the study group was lower than that of the control group when the patient was awakened, and the extubation time was shorter than that of the control group (P<0.05). (4) The incidence of cardiovascular events during the follow-up of the observation group was 10.87%, which was significantly lower than 28.26% of the control group (P<0.05). At the same time, 1 patient died during the two follow-up periods. Conclusion: Interventional therapy for patients with cardiovascular and cerebrovascular diseases can significantly stabilize the hemodynamics of patients with dexmedetomidine combined with sevoflurane. It can also improve the patient's recovery state and relieve the stress response of patients with the weakening of anesthesia, and reduce the occurrence of cardiovascular and cerebrovascular events and improve the prognosis. |
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