不同剂量右美托咪啶对老年患者血流动力学影响的临床分析

Influence analysis of different doses of dexmedetomidine for the hemodynamic of elderly patients

目的分析不同剂量右美托咪啶对诱导插管期老年高血压患者血流动力学的影响。方法选择在北京健宫医院行腹部手术的老年高血压患者80例，随机分为四组：A组、B组、C组、和D组，分别于麻醉诱导前静脉输注浓度为0．3pg／kg、0．4μg／蛞、0．5μg/kg和0．6μg/kg的右关托咪啶，依次记录患者输注右美托咪啶前（哟）、输注右美托咪啶后（T1）、气管插管即刻（T2）、气管插管后1min（13）、气管插管后3min（T4）、气管插管后5min（T5）的桡动脉收缩压（SAP）、舒张压（DAP）及心率（HR）。结果他时刻A组SAP、DAP、HR分别为（129．8±12．9）mmHg、（68．3±13．1）mmHg、（65．4±13．6）次／min；B组SAP、DAP、HR分另1为（127．2±13．0）mmHg、（67．2±12．1）mmHg、（65．1±13．1）次／min；C组SAP、DAP、HR分别为（141．8±15．1）mmHg、（74．1±14．1）mmHg、（70．4±13．1）次/min，D组SAP、DAP、HR分别为（141．1±13．1）mmHg、（75．2±12．1）mmHg、（71．2±11．0）次／min。T1及12时刻四组三项指标均有所下降；T2时刻A组和B组三项指标显著下降（P〈0．05），C组及D组无显著下降；T3时刻A组及B组三项指标较12时刻显著上升（P〈0．05），而C组及D组指标无显著改变；T4及T5时刻四组三项治疗较11D时刻均无显著改变（P〉0．05）。结论全麻诱导前静脉输注0．5μg／kg或0．6μg/k浓度右美托咪啶可稳定老年高血压患者血流动力学波动，且安全性佳。

Objective To analyze the effect of different doses of dexmedetomidine on the hemo- dynamics of elderly patients. Methods Eighty elderly patients treated with abdominal surgery in our hospital were selected and divided into four groups： group A（0. 3μg/kg）, group B（0. 4μg/kg）, group C （0. 5μg/kg） and group D（0. 6μg/kg）. SAP, DAP and HR in six time points, which included before injection of dexmedetomidine, post injection of dexmedetomidine, tracheal intubation, lmin after tracheal intubation, 3min after tracheal intubation, 5min tracheal intubation, were analyzed. Results The levels of SAP, DAP and HR of the four groups at T1 and T2 declined. The levels of SAP, DAP and HR of group and group B at T2 significantly declined （ P 〈 0. 05 ）. The levels of SAP, DAP and HR of group A and group B at 33 were significantly higher than those of T2 （P 〈 0. 05 ）. Conclusions The dose of dexmedetomidine in 0. 5 μg/kg and 0. 6 μg/kg can stabilize hemodynamic of elderly patients with hypertension.