右美托咪定联合尼卡地平控制性降压在腰椎间盘手术中的临床应用研究

Clinical Study of Controlled Hypotension with Dexmedetomidine Plus Nicardipine During Lumbar Disc Surgery

目的:探究右美托咪定联合尼卡地平控制性降压在腰椎间盘手术中的临床应用效果。方法:选取本院2018年4月~2019年4月收治的90例实施腰椎间盘手术的腰椎间盘突出症(lumbar disc herniation,LDH)患者为研究对象,采用随机数字表法将其分为治疗A组(右美托咪定联合尼卡地平)与治疗B组(尼卡地平)控制性降压,每组45例;探讨实施不同治疗对治疗效果的影响。结果:T_(1)时,两组心率(HR)、平均动脉压(MAP)指标无统计学差异(P> 0.05)。T_(2)~T_(4)时,治疗A组指标均低于治疗B组(P <0.05);治疗A组躁动、蒙特利尔认知评估(MOCA)、满意度评分均高于治疗B组(P <0.05);治疗A组降压至目标血压的时间、拔管时间、血压恢复时间均短于治疗B组(P <0.05)。结论:在腰椎间盘手术中给予右美托咪定联合尼卡地平控制性降压后,可减轻躁动、提升认知功能及满意度,血压控制效果较好,此方法值得临床应用与推广。

Objective:To study the clinical application of controlled hypotension with dexmedetomidine plus nicardipine during lumbar disc surgery.Methods:90 lumbar disc herniation(LDH)patients received surgery in our hospital from April 2018 to April 2019 were chosen as research subjects.According to random number table method,patients were assigned to group A(dexmedetomidine plus nicardipine)and group B(nicardipine),45 cases in each group.Therapeutic effects were probed.Results:At T1,heart rate(HR)and mean arterial pressure(MAP)of two groups were not significantly different(P>0.05);at T_(2)~T_(4),HR and MAP in group A were lower than those of group B(P<0.05);dysphoria,scores of Montreal Cognitive Assessment(MOCA)and clinical satisfaction scores in group A were higher than those of group B(P<0.05);time of reaching the targeted blood pressure,extubation time and blood pressure recovery time in group A were significantly shorter than those of group B(P<0.05).Conclusion:During lumbar disc surgery,the controlled hypotension with dexmedetomidine and nicardipine can relieve dysphoria,improve the cognitive function and clinical satisfaction,control blood pressure,which is worthy of clinical application and promotion.