论文部分内容阅读
目的：比较经鼻滴入不同剂量右美托咪定和静脉泵注右美托咪定对全麻插管期应激反应的影响。方法选择80例择期行胃癌根治术的患者，随机分为四组，每组各20例。C组为盐水对照组；B组静脉泵注组，在麻醉诱导前10min内将0．5μg／kg右美托咪定泵入；D1组和D2组为经鼻滴注，分别于麻醉诱导前10min经鼻滴注右美托咪定0．5μg／kg和1μg／kg。记录三组患者：入室时（给予右美托咪定前）（T0）、气管插管前（T1）、气管插管毕即刻（T2）、切皮前（T3）各时点心率（HR）、收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、血浆皮质醇（Cor）和血糖（Glu）浓度。结果在T2时刻 HR、SBP、DBP、MAP ，C组高于B组和D2组（ P＜0．05）；D1组高于D2组（ P＜0．05），B组和D2组之间差异无统计学意义（ P＞0．05）；C组患者在切皮前（T3）Cor与Glu浓度高于B组、D2组（P＜0．05）；D1组在 T3时刻Cor与Glu浓度高于D2组，差异有统计学意义（ P＜0．05）。结论经鼻滴注1μg ／kg右美托咪定与静脉泵注右美托咪定0．5μg／kg抑制气管插管的应激反应效果相似，而经鼻滴注避免了静脉给药的不良反应，更适于临床应用。“,”Objective To compare the effects of different doses of dexmedetomidineon administered with a micro infusion pump or nasal drops on stress reflect to endotrachael intubation .Methods Totally 80 pa-tients underwent radical operation for gastric cancer were selected as subjects .They were divided into four groups randomly ,20 cases in each group .Dexmedetomidine group(group B)were given 0 .5μg /kg with amicro infusion pump ,0 .5μg /kg and 1μg /kg dexmedetomidine was respectively injected with nasal drops in the group D1 and D2 ,while group C was offered the same amount of physiological saline .Endotracheal intubation was placed after dexmedetomidine and saline were administered 10 minutes .The parameters of heart rate (HR) ,systolic blood pressure (SBP) ,diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded in the following time:just entering operating room (before Dex be given)(T0 );im-mediately before intubation(T1 );immediately afert intubation (T2 );before cut the skin(T3 ) .The level of corticosteroid (Cor) and glucose (Glu) in the arterial blood was measured .Results Group C compared with group B and D2 of hemodynamic had obviously statistical differences at the time of T2 (P<0 .05) ,the comparison of hemodynamic had also obviously differences(P0 .05) .Cor and Glu in group C at T3 time were higher than that in group B and D2 (P<0 .05) ,and they were higher in group D1 than that in group D2 .Conclu-sion Anesthesia induction by 0 .5μg /kg dexmedetomidine administered with a micro infusion pump or 1μg/kg administered with nasal drops can all be safely used clinical ,and the adverse reaction of pumped can be avoided when 1μg /kg dexmedetomidine is administered with nasal drops ,so it can be recommended as the best dose for clinical used .