论文部分内容阅读
目的:比较不同剂量右美托咪啶用于老年高血压患者全麻诱导期的麻醉效果。方法:前瞻性分析2017年7月至2019年12月在中国医科大学肿瘤医院诊治的老年高血压患者145例，采用随机数字表法分为高剂量组(0.6 μg/kg右美托咪啶)74例和低剂量组(0.2 μg/kg右美托咪啶)71例，比较两组诱导前(Tn 0)、输注右美托咪啶20 min(Tn 1)、全麻诱导后(Tn 2)、气管插管后1 min(Tn 3)、气管插管后3 min(Tn 4)、气管插管后5 min(Tn 5)的血流动力学指标，以及患者的拔管时间、睁眼时间和不良反应发生情况。n 结果:两组血流动力学指标在Tn 1、Tn 2、Tn 3、Tn 4、Tn 5时与Tn 0比较均显著降低(n P<0.05)，但高剂量组心率(HR)在Tn 2、Tn 3、Tn 4、Tn 5时明显高于低剂量组(n P<0.05)，收缩压(SBP)在Tn 1、Tn 2时明显高于低剂量组(n P<0.05)，舒张压(DBP)在Tn 2、Tn 5时明显高于低剂量组(n P<0.05)，平均动脉压(MAP)在Tn 1时明显高于低剂量组(n P<0.05)。高剂量组的拔管时间、睁眼时间均显著长于低剂量组(n P0.05)。n 结论:相对于0.2 μg/kg右美托咪啶，采用0.6 μg/kg右美托咪啶用于老年高血压患者的全麻诱导中，对血流动力学的稳定效果更佳，且不会增加不良反应，但患者苏醒时间和睁眼时间相对较长。“,”Objective:To compare the anesthesia effects of different doses of dexmedetomidine in the induction period of general anesthesia in elderly hypertensive patients.Methods:A prospective analysis of 145 elderly patients with hypertension treated in Cancer Hospital of China Medical University from July 2017 to December 2019 was conducted. The patients were randomly divided into high-dose group (0.6 μg/kg dexmedetomidine) with 74 cases and low-dose group (0.2 μg/kg dexmedetomidine) with 71 cases. The hemodynamic indexes before induction (T n 0), 20 min after dexmedetomidine infusion (Tn 1), after induction of general anesthesia (Tn 2), 1 min after tracheal intubation (Tn 3), 3 min after tracheal intubation (Tn 4) and 5 min after tracheal intubation (Tn 5), as well as the extubation time, eye opening time and adverse reactions were compared between the two groups.n Results:Compared with Tn 0, hemodynamic indexes of the two groups were significantly decreased at Tn 1, Tn 2, Tn 3, Tn 4 and Tn 5 (n P<0.05). The heart rate (HR) at Tn 2, Tn 3, Tn 4 and Tn 5, systolic blood pressure (SBP) at Tn 1 and Tn 2, diastolic blood pressure (DBP) at Tn 2 and Tn 5, mean arterial pressure (MAP) at Tn 1 in high-dose group were significantly higher than those of low-dose group (n P<0.05). The extubation time and eye opening time of high dose group were significantly longer than those of low dose group (n P0.05).n Conclusions:Compared with 0.2 μg/kg dexmedetomidine, 0.6 μg/kg dexmedetomidine used in the induction of general anesthesia in elderly patients with hypertension has better hemodynamic stability, and does not increase adverse reactions, but the recovery time and eye opening time of patients are relatively long.