右美托咪定在下肢深静脉血栓介入治疗中的应用

Application of dexmedetomidine in interventional therapy of lower extremity deep vein thrombosis

目的 研究右美托咪定在下肢深静脉血栓介入治疗中的应用。方法选取2013年1月至2015年7月在该院择期行下肢深静脉血栓介入治疗的患者40例,采用随机数字表法将其分为右美托咪定组和对照组,各20例。右美托咪定组于术前静脉滴注右美托咪定负荷量1μg/kg,时间大于10 min,随后以0.5μg/（kg·h）维持至手术结束;对照组给予等量生理盐水。采用视觉模拟评分（VAS评分）和Ramsay镇静评分评价镇痛、镇静效果。记录术中高血压、心动过缓、低氧血症等不良反应。结果 与对照组比较,右美托咪定组患者VAS评分于T2~5时降低,Ramsay评分于T2~5时增高,术中心动过缓增加,高血压发生率降低,差异均有统计学意义（P〈0.05）。与T1时比较,对照组VAS评分于T5时降低,Ramsay评分于T5时增高,差异均有统计学意义（P〈0.05）。结论 右美托咪定具有良好镇痛和镇静效果,能维持下肢深静脉血栓介入治疗术中血流动力学稳定。

Objective To evaluate the application of dexmedetomidine in the interventional therapy of lower extremity deep vein thrombosis (DVT). Methods Forty patients with elective lower extremity DVT interventional therapy in our hospital from January 2013 to July 2015 were selected and randomly assigned into the dexmedetomidine group and the control group ,20 cases in each group. The dexmedetomidine group was intravenously dripped with load dose of dexmedetomidine 1 μg/kg for more than 10 min before surgery,then dexmedetomidine 0.5 μg/(kg·h) was maintained via pumping during surgery until the end of surgery;whereas the equal volume of normal saline was given in the control group C. The VAS score and Ramsay sedation score were adopted to evaluate the analgesia and sedation effects. The adverse reactions such as intraoperative hypertension ,bradycar-dia and hyoxemia were also recorded. Results Compared with the control group,the VAS scores at T2-5 in the dexmedetomidine group were decreased,while the Ramsay scores were increased,intraoperative bradycardia was increased and occurrence rate of hypertension was decreased,the differences were statistically significant(P<0.05). Compared with T1,the VAS scores at T5 in the control group was decreased,while the Ramsay scores were increased,the differences were statistical different(P<0.05). Conclu-sion Dexmedetomidine has better analgesic and sedative effects and can maintain the hemodynamic stability during the lower extremity DVT interventional therapy.