右美托咪啶对高血压患者全麻拔管期血浆儿茶酚胺影响.docVIP

右美托咪啶对高血压患者全麻拔管期血浆儿茶酚胺影响 　　[摘要] 目的 观察右美托咪啶对高血压患者全麻拔管期血浆儿茶酚胺浓度的影响，为右美托咪啶在高血压患者中的合理应用提供依据。 方法 选择2013年5月～2015年7月重庆医科大学附属永川医院收治的原发性高血压病患者30例为研究对象，所有患者均择期行腹腔镜胆囊切除术，将其随机分为A组（0.5 μg/kg右美托咪啶剂量组）、B组（0.3 μg/kg右美托咪啶剂量组）和C组（生理盐水对照组），每组各10例。常规麻醉诱导与维持，手术结束切口缝合完毕前15 min，各组泵注相应剂量的右美托咪啶或同体积生理盐水，泵注10 min。测定各组患者用药前（T0）、用药结束后5 min（T1）、拔管后5 min（T2）血浆儿茶酚胺浓度。 结果 组内比较：T1与T0比较，A组血浆肾上腺素、去甲肾上腺素浓度明显降低（P 0.05）；在T1、T2时点，A组血浆肾上腺素、去甲肾上腺素浓度明显低于C组（P 0.05）；T1时点A组血浆去甲肾上腺素浓度明显低于B组（P 0.05）；T2时点A组血浆肾上腺素、去甲肾上腺素浓度明显低于B组（P 0.05）。 结论 右美托咪啶可明显抑制高血压患者全麻拔管期应激引起的血浆儿茶胺浓度升高，且以0.5 μg/kg剂量为宜。 　　[关键词] 右美托咪啶；血浆儿茶酚胺；全麻拔管期；高血压 　　[中图分类号] R614.1 [文献标识码] A [文章编号] 1673-7210（2016）01（a）-0079-04 　　Effect of Dexmedetomidine on plasma catecholamines of patients with hypertension in extubating period of general anesthesia 　　YANG Liu JIANG Wei SHUI Chunling YANG Jianping 　　Department of Anesthesia， Affiliated Yongchuan Hospital of Chongqing Medical University， Chongqing 402160， China 　　[Abstract] Objective To investigate the effect of Dexmedetomindine on plasma catecholamine concentrations of patients with hypertension in extubating period of general anesthesia， and provide a basis for reasonable application of Dexmedetomidine in patients with hypertension. Methods From May 2013 to July 2015， 30 patients with essential hypertension undergoing elective laparoscopic cholecystectomy in Affiliated Yongchuan Hospital of Chongqing Medical University were selected as study objects， and they were randomly divided into three groups， group A （0.5 μg/kg Dexmedetomidine group）， group B （0.3 μg/kg Dexmedetomidine group）， and group C （saline group）， 10 cases in each group. 15 minutes before the end of operation， patients were given Dexmedetomidine or the same volume of physiological saline infusion， for 10 minutes. Plasma catecholamine concentration was determined at T0 （before treatment）， T1 （5 min after treatment）， T2 （5 min after extubation）. Results Comparison within groups， concentrations of plasma epinephrine and norepinephrin