右美托咪定对冠心病行腹腔镜胆囊切除术患者凝血功能及Cor水平影响.docVIP

右美托咪定对冠心病行腹腔镜胆囊切除术患者凝血功能及Cor水平影响 　　[摘要] 目的 ?^察右美托咪定（Dexmedetomidine，Dex）对冠心病行腹腔镜胆囊切除术患者凝血功能及Cor水平的影响。 方法 选择符合2013年美国制定的有关高脂血症的诊断标准和1979年WHO制定的有关冠心病的诊断标准，择期拟行腹腔镜胆囊切除的高脂血症合并冠心病患者40例。随机分为右美托咪定 0.6 μg/kg组（D组）和生理盐水对照组（C组），每组20例。均采用静吸复合全麻，麻醉诱导前10 min D组患者静脉泵注右美托咪定0.6 μg/kg（10 min 注完），输注时间30 min；C组与D 组用同样方式输注等剂量0.9%氯化钠溶液。给药后2 h取肘静脉血测定凝血功能及应激反应指标：PT、APTT、TT、FIB水平及血Cor水平，并记录手术时间、麻醉时间、手术出血量、拔管时间。 结果 D组术后2 h、术后24 h的血Cor水平明显低于C组，两组比较差异有统计学意义（P0.05）。 结论 右美托咪定能改善冠心病腹腔镜胆囊切除术患者的高凝状态，并明显抑制气管拔管期引起的应激反应，不延迟术后苏醒，不增加手术出血量，适用于冠心病患者围术期。 　　[关键词] 右美托咪定；腹腔镜胆囊切除术；冠心病；凝血功能；Cor水平 　　[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2018）06-0118-03 　　[Abstract] Objective To investigate the effect of dexmedetomidine（Dex） on the coagulation function and Cor level in patients with coronary heart disease undergoing laparoscopic cholecystectomy. Methods 40 patients with hyperlipidemia complicated with coronary heart disease who underwent laparoscopic cholecystectomy were selected according to the diagnostic criteria of hyperlipidemia developed by the United States in 2013 and the diagnostic criteria of coronary heart disease established by the WHO in 1979. The patients were randomly divided into dexmedetomidine 0.6 μg/kg group（group D） and normal saline control group（group C）， with 20 patients in each group. The patients were all given intravenous inhalation combined with general anesthesia. The patients in group D were intravenously injected with dexmedetomidine 0.6 μg/kg（10 min injection） 10 minutes before induction of anesthesia， and the infusion time was 30 min； group C were equally injected with 0.9% sodium chloride solution with the same manner. 2 h after administration， the elbow venous blood was collected to measure the coagulation function and stress response indicators： PT， APTT， TT， FIB levels and blood Cor levels. The operation time， anesthesia time， surgical bleeding volume and extubation time were recorded. Results The level of blood Cor in group D at 2 h， 24 h after operation was significant