中国医学创新2016，Vol.13Issue(30)：84-88,5.DOI:10.3969/j.issn.1674-4985.2016.30.023
右美托咪定对全麻经皮肾镜取石术患者血流动力学及应激反应的影响
Effect of Dexmedetomidine on Hemodynamics and Stress Reaction in Patients Undergoing Percutaneous Nephrolithotomy with General Anesthesia
摘要
Abstract
Objective:To investigate the effect of Dexmedetomidine on circulation and stress reaction in patients undergoing percutaneous nephrolithotomy with general anesthesia.Method:From August 2014 to March 2016,75 cases of undergoing percutaneous nephrolithotomy with general anesthesia in our hospital were selected as the research objects,they were randomly divided into the Dex low dose group(group D1),high dose group(group D2) and control group(group C),each group had 25 cases.Group D1 and D2 were given 0.5 μg/kg and 1.0 μg/kg loading dose of Dex within 10 min before endotrachael intubation,while 0.2 μg/(kg·h) and 0.4 μg/(kg·h) were pumped with micropump until the end of the operation.Group C was offered the same amount of physiological saline.The parameters of heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP) were recorded before anesthesia induction(T0),immediately after intubation(T1),insertion of ureter by urethra(T2), 10 min after prone position(T3),when renal puncture(T4),30 min started lithotripsy(T5),60 min started lithotripsy(T6) and 5 min after extubation(T7).Concentrations of blood epinephrine(E),norepinephrine(NE), cortisol(Cor)and glucose(Glu) were measured at T0,T1,T4,T5,T6 and T7 time.The number of restless were occurred after operation according to the agitation score.Result:Compared with T0,SBP and DBP at T1,T4-T7and HR at T1-T7 in group C were increased significantly(P<0.05),and there were no significant differences at T1-T7 in group D1 and D2.Compared with group C,SBP and DBP at T1,T4-T7 and HR at T1-T7 in group D1 and D2 were decreased significantly(P<0.05).Compared with group D1,HR at T2 and T5 in group D2 was decreased significantly (P<0.05).Concentrations of blood E,NE and Cor at T1,T4-T7 were increased significantly in three groups than T0.Compared with group C,concentrations of blood E,NE and Cor at T1,T4-T7 in group D1 and D2 were decreased significantly(P<0.05).Compared with T0,concentrations of blood Glu at T1,T4-T7 in group C and at T4-T7 in group D1 and D2 were increased significantly(P<0.05).Compared with group C,concentrations of blood Glu at T4-T7 in group D1 and D2 were decreased significantly(P<0.05).21 cases(84%) and 22 cases (88%)agitation score respectively were 0-1 in group D1 and D2,all more than 14 cases(56%) in group C(P<0.05).Conclusion:Dexmedetomidine can increase hemodynamic stability during perioperative period,effectively reduce the stress reaction undergoing percutaneous nephrolithotomy with general anesthesia,create a favorable condition for the operation.关键词
右美托咪定/经皮肾镜取石术/血流动力学/应激反应Key words
Dexmedetomidine/Percutaneous nephrolithotomy/Hemodynamics/Stress reaction引用本文复制引用
黄重峰,焦丰,潘英芳,李铨华,郭名文,吴文鴶..右美托咪定对全麻经皮肾镜取石术患者血流动力学及应激反应的影响[J].中国医学创新,2016,13(30):84-88,5.基金项目
2014年赣州市科技计划项目[赣市财教字（2014）131号] （）
