作　　者： (吴静）; (罗晓刚）;

机构地区： 湖北中医药大学黄家湖医院麻醉科,湖北武汉431700

出　　处： 《中国医药导刊》 2017年第8期783-786,共4页

摘　　要： 目的:探讨脓毒症患者全麻时,常规麻醉诱导前静脉输注右美托咪定对其肺的保护作用。方法:将拟于我院治疗的脓肿合并脓毒症休克患者68例随机分为观察组(n=34)和对照组(n=34)。两组患者均采取全身静脉麻醉后行脓肿切除术。观察组麻醉诱导前静脉输注右美托咪定,对照组输注等容量生理盐水。于两组麻醉诱导前(T_0),气管插管成功后即刻(T_1),手术开始30 min(T_2),手术结束时(T_3),拔除气管导管后(T_4)抽取静脉血行肺泡-动脉氧分压差(Aa DO_2)、氧合指数(OI)、呼吸指数(RI),同时监测T_0~T_4的平均动脉压(MAP)和心率(HR)。同时比较两组患者的手术时间、术中出血量和住院天数。结果:与T_0比较,两组患者T_1、T_2、T_3时Aa DO_2都升高,RI则先下降后升高,OI在T_1、T_2、T_3时均下降(P<0.05)。两组患者T_4与T_0比较各指标差异无统计学意义(P>0.05)。观察组Aa DO_2、RI在T_1、T_2、T_3时低于对照组,OI在T_1、T_2、T_3时高于对照组(P<0.05)。两组患者在T_0时MAP和HR差异比较无统计学意义(P>0.05)。观察组患者T_2~T_4的MAP和HR均明显低于对照组(P<0.05)。两组患者手术时间、术中出血量和住院天数比较差异无统计学意义(P>0.05)。结论:脓毒症患者全麻时常规麻醉诱导前静脉输注右美托咪定可维持保持相对稳定的MAP和HR,对患者肺脏起到一定的保护作用。 Objective：To study the protection for sepsis patients’ lungs in general anesthesia induced by intravenous infusion dexmedetomidine.Methods：68 cases of patients with sepsis were randomly divided into observation group （n=34） and control group （n=34）. Two groups of patients were taken general intravenous anesthesia before abscess after resection. The observation group patients with general anesthesia was induced by intravenous dexmedetomidine infusion. Control group were taken physiological saline with same capacity. Two groups of patients blood was draw before anesthesia induction （T0）, the immediately time of endotracheal intubation after a successful operation （T1）, after operation started 30 min （T2）, the time of surgery end （T3）, after pulling the endotracheal tube（T4）. Venous blood was taken to compare alveolar -arterial oxygen partial pressure difference （AaDO2）, oxygenation index （OI）, respiratory index （RI）, at the same time, mean arterial pressure （MAP） and heart rate （HR） in T0-T4 were monitored.The operation time, intraoperative blood loss and hospitalization days of patients in two groups was compared. Results：Compared with T0, two group patients’ AaDO2 was increased, RI was increased after decreasing, OI was decreased in T1-T3（P〈0.05）, compared with T0 two groups of patients’all indexes in T4 had no statistical significance （P〉0.05）. Observation group AaDO2 and RI were lower than the control group in T1-T3, OI in T1-T3 was higher than the control group （P〈0.05）. The MAP and HR had no statistical significance in two groups of patients in T0 （P〉0.05）. The MAP and HR of observation group of patients in T2 to T4 were significantly lower than the control group （P〈0.05）. The operation time, intraoperative blood loss and hospitalization days of patients in two groups were no statistically significant difference （P〉0.05）.Conclusion： Sepsis patients during general anesthesia induced by intravenous infusion dexmede

关 键 词： 右美托咪定 脓毒症 肺 保护 全麻