右美托咪定在2型糖尿病患者全身麻醉中的临床应用分析

Clinical Application Analysis of Dexmedetomidine in General Anesthesia in Type 2 Diabetic Patients

目的探讨右美托咪定在2型糖尿病患者全身麻醉中的临床应用效果。方法于2017年1月—2019年9月选择该院接受气管插管全身麻醉手术的120例2型糖尿病患者作为研究对象,依据随机数字表法分组,每组60例。麻醉诱导前观察组给予右美托咪定,对照组给予安慰剂生理盐水。比较两组麻醉效果、生命体征指标、术后麻醉苏醒情况、血糖水平、认知功能评分。结果麻醉优良率观察组96.67%与对照组93.33%相比差异无统计学意义(P>0.05)。对比插管前,观察组患者在插管后心率、血压变化差异无统计学意义(P>0.05),但是插管后对照组的心率和血压显著升高,差异有统计学意义(P<0.05)。两组术后恢复自主呼吸时间、睁眼唤醒时间、恢复意识时间以及拔管时间在两组组间比较,观察组显著缩短,差异有统计学意义(P<0.05)。手术前,两组空腹血糖比较差异无统计学意义(P>0.05),而手术结束时、术后6 h观察组的空腹血糖均低于对照组,差异有统计学意义(P<0.05)。手术结束后,两组的MMSE、MoCA评分与术前相比都有显著降低,但是观察组的MMSE、MoCA评分更高,差异有统计学意义(P<0.05)。结论右美托咪定用于2型糖尿病患者气管插管全身麻醉手术中,可保证麻醉效果,减轻气管插管引起的生命体征波动,还可加快患者术后苏醒,减轻患者术后血糖波动和认知功能障碍。

Objective To investigate the clinical application effect of dexmedetomidine in general anesthesia in patients with type 2 diabetes.Methods From January 2017 to September 2019,120 patients with type 2 diabetes who underwent general anesthesia for tracheal intubation in the hospital were selected as the research objects.They were grouped according to the random number table method,60 cases in each group.Prior to anesthesia induction the observation group was given right Medetomidine,the control group was given placebo saline.Compared anesthesia effect,vital signs,postoperative anesthesia recovery,blood glucose level,cognitive function score.Results 96.67%of the excellent and good rate of anesthesia in the observation group had no statistical difference compared with 93.33% in the control group,the difference was not statistically significant(P>0.05).Before intubation,the heart rate and blood pressure of patients in the observation group did not change much after intubation,the difference was not statistically significant(P>0.05),but the heart rate and blood pressure of the control group increased significantly after intubation(P<0.05).The time for patients to regain spontaneous breathing after operation,the time to wake up with eyes open,the time to regain consciousness and the time to extubation were compared between the two groups,and the observation group was significantly shorter,and the difference was statistically significant(P<0.05).Before the operation,there was no statistically significant difference in fasting blood glucose between the two groups(P>0.05),while the fasting blood glucose of the observation group was lower than the control group at the end of the operation and 6 h after the operation,and the difference was statistically significant(P<0.05).After the operation,the MMSE and MoCA scores of the two groups were significantly lower than those before the operation,but the MMSE and MoCA scores of the observation group were higher,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine is used in general anesthesia for tracheal intubation in type 2 diabetic patients,which can ensure the anesthesia effect,reduce the fluctuation of vital signs caused by tracheal intubation,and speed up the patient’s postoperative recovery and reduce blood glucose fluctuations and cognitive dysfunction after surgery.