右美托咪定复合瑞芬太尼在无痛ERCP中临床观察.docVIP

右美托咪定复合瑞芬太尼在无痛ERCP中临床观察 　　[摘要] 目的 探讨右美托咪定复合瑞芬太尼在ERCP中的有效性及安全性。方法 方便选择拟行ERCP术的患者62例，将其按照麻醉方法分为A组和B组，A组给予右美托咪定复合瑞芬太尼麻醉，B组患者给予丙泊酚复合瑞芬太尼麻醉，分别记录2组患者个各时段血压、HR、呼吸频率（RR）等相关指标。 结果 手术开始后，B组患者在各时间点的SBP、DBP和HR均明显高于A组 （P0.05）；两组患者呼吸频率在插镜、套石、退镜各时点相比差异具有统计学意义（P0.05），而在睁眼时则差异不明显。A组呼吸抑制、心动过缓分别为2例、12例，对照组分别为12例、2例。 结论 右美托咪定复合瑞芬太尼可可安全有效地应用于ERCP操作。 　　[关键词] 右美托咪定；瑞芬太尼；ERCP 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）05（a）-0131-02 　　[Abstract] Objective To discuss the effectiveness and safety of dexmedetomidine and remifentanil in the ERCP. Methods 62 cases of patients planning for ERCP operation were selected and divided into two groups according to different anaesthesia methods， the group A were given dexmedetomidine and remifentanil for anaesthesia， the group B were given propofol and remifentanil for anaesthesia， and the relevant indexes including blood pressures in each period， HR and respiratory rates of the two groups were respectively recorded. Results After the operation began， the SBP， DBP and HR in each time point in the group B were obviously higher than those in the group A， P0.05， and there were obvious differences in the respiratory rates between the two groups at the time of inserting endoscope， spiral stone dislodge and endoscope withdrawal， P0.05， but the difference in the respiratory rate between the two groups at the time of eyes open was not obvious， respiratory depression occurred to 2 cases and bradyarrhythmia occurred to 12 cases in the group A and respiratory depression occurred to 12 cases and bradyarrhythmia occurred to 2 cases in the control group. Conclusion Dexmedetomidine and remifentanil can effectively and safely apply to the ERCP operation. 　　[Key words] Dexmedetomidine； Remifentanil； ERCP 　　. 　　患者在接受经内镜逆行胰胆管造影（ERCP）时，对胃肠道的伤害加大，同时还不能避免手术应激，对患者的生命安全造成不可估量的风险，因此ERCP在临床应用上收到患者的拒绝[1]。面对此种情况给予患者安全有效的麻醉非常必要，相关研究资料表明[2]，右美托咪定属高选择性α肾上腺素能受体激动剂，临床因其均有催眠优点得到广泛应用。该文便对该院2012年2月―2014年2月期间收治的行EPCP进行麻醉，对比不同麻醉方案的临床疗效及其安全性，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　方便选取201