右美托咪定对冠心病患者围手术期心率和血压的影响

The Influence of Dexmedetomidine on Perioperative Period Heart Rate and Blood Pressure in Coronary Artery Disease Patients

目的：探讨静脉使用右美托咪定对冠心病患者腹部于术在整个同手术期心率、血压的影响。方法：选取择期行腹部手术冠心病患者80例，年龄55～73岁，ASAⅠ-Ⅱ级，按照随机数字表法将其分为右美托咪定组（D组）和对照组（C组）各4（1例。13组在麻醉开始时泵注右美托咪定0-3μg/（kg·h），C组注射等量的生理盐水。两组患者人手术室后监测并记录麻醉诱导前（T0）、麻醉诱导后（T1）、气管插管后（T2）、手术开始（T3）和手术结束时（T4）的心率和血压变化情况。结果：与TO比较，两组患者在T1～T3时点的心率（HR）减慢，SBP及DBP均明显降低，差异均有统计学意义（P〈0．05），D组在T4时点的SBP及DBP升高的值均明显低于C组，差异均有统计学意义（P〈0．05）。结论：静脉使用右美托咪定对抑制冠心病患者腹部手术围术期应激反应有显著的作用，使崮术期手术刺激反应对心脏自主神经功能的干扰降到最低，具有一定的心肌保护作用。

Objective： To investigate the influence of dexmedetomidinc on perioperative heart rate and blood pressure in coronary artery disease patients abdominal operation.Method： Eighty patients with coronary heart disease underwent elective abdominal operation were selected, the aged between 55 and 73 years, ASA Ⅰ-Ⅱ, they were divided into the dexmedetomidine group （ the group D ） and the control group （ the group C ）, 40 cases in each group. Dexmedetomidine 0.3 μ g/ （ kg ·h ） was pumped into the group D when the anesthesia induction began, the same amount of physiological saline was injected into the group C.Changes of heart rate and blood pressure between the two groups were monitored and recorded before anesthesia induction （ TO ）, after anesthesia induction （ T1 ）, after endotracheal intubation （ T2 ）, the operation begin （ T3 ）, ＇after surgery （ T4 ） after entering operation room.Result ： Competed with TO, the HR, SBP and DBP of the two groups were declined between T1 and T3, the differences were statistically significant （ P〈0.05 ） . SBP and DBP in group D were statistically lower than those of group C at T4, the differences were statistically significant （ P〈0.05 ） .Conclusion： Dexmedetomidine intravenous injection has a great protective effect on perioperative period heart rate and blood pressure in coronary artery disease patients, can make the perioperative surgical stimulation reaction of cardiac autonomic nervous function of the interference to a minimum, has a myocardial protective role.