[1]胡杰**,陈兴澎①,郑海涛①.右美托咪定在主动脉夹层覆膜支架腔内隔绝术中的应用[J].中国微创外科杂志,2018,18(1):47-71.
　Hu Jie*,Chen Xingpeng,Zheng Haitao..Application of Dexmedetomidine for Endovascular Stent Graft Exclusion for Aortic Dissection[J].Chinese Journal of Minimally Invasive Surgery,2018,18(1):47-71.
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右美托咪定在主动脉夹层覆膜支架腔内隔绝术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年1期
页码:
47-71
栏目:
临床研究
出版日期:
2018-03-21

文章信息/Info

Title:
Application of Dexmedetomidine for Endovascular Stent Graft Exclusion for Aortic Dissection
作者:
胡杰**; 陈兴澎①; 郑海涛①
郑州大学附属洛阳中心医院麻醉科，洛阳471009
Author(s):
Hu Jie*;  Chen Xingpeng;  Zheng Haitao.
*Department of Anesthesiology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471009, China
关键词:
右美托咪定; 主动脉夹层; 支架
Keywords:
Dexmedetomidine; Aortic dissection; Stent
文献标志码:
A
摘要:
目的探讨右美托咪定在主动脉夹层覆膜支架腔内隔绝术中应用的安全性和有效性。方法选取2015年1月～2016年12月在我院手术治疗的DeBakey Ⅲ型主动脉夹层82例，按随机数字表分为试验组和对照组，试验组15 min泵注右美托咪定1 μg/kg，然后按0.3 μg·kg-1·h-1持续泵注，对照组泵注丙泊酚4~6 μg·kg-1·h-1，靶控输注瑞芬太尼3~5 μg/L，2组患者再辅以切口局部麻醉进行手术。观察麻醉前基础值（T0）、麻醉诱导后（T1）、切皮（T2）、术毕（T3）4个时间点Ramsay评分、MAP和SpO2。结果试验组患者Ramsay评分在T0、T1、T2、T3时点均显著低于对照组［T0:（1.8±0.4）分 vs. (2.1±0.6)分，t=2.664,P=0.009；T1:（2.8±0.3）分 vs. (5.1±0.4)分，t=29.454,P=0.000；T2:（3.0±0.5）分 vs. (4.8±0.3)分，t=19.766,P=0.000；T3:（2.9±0.4）分 vs. (3.9±0.6)分，t=8.880,P=0.000］。试验组MAP在T1时点明显高于对照组［（76.2±10.1）mm Hg vs. (67.2±11.4) mm Hg，t=-3.784,P=0.002］，其他时点2组无统计学差异（P>0.05）。SpO2 T0、T1、T2时点试验组明显高于对照组［T0:（96.0±1.0）％ vs. (95.0±1.5)％，t=-3.552,P=0.000；T1:（95.5±11）％ vs. (90.0±1.5)％，t=-18.933,P=0.000；T2:（95.0±1.3）％ vs.(90.8±1.1)％，t=-15.792,P=0.000］，T3时点2组比较无统计学差异（t=0.220,P=0.827）。结论右美托咪定可安全地用于主动脉夹层覆膜支架腔内隔绝术。
Abstract:
ObjectiveTo evaluate the efficacy and safety of dexmedetomidine applied in the endovascular stent graft exclusion for aortic dissection.MethodsFrom January 2015 to December 2016, 82 patients with type DeBakey Ⅲ aortic dissection in our hospital were divided into either experimental group or control group according to random number table. In the experimental group, patients were given 15 min infusion of dexmedetomidine at 1 μg/kg, followed by 0.3 μg·kg-1·h-1 continuous infusion. In the control group, patients were given propofol infusion at 4-6 μg·kg-1·h-1 combined with target controlled infusion of remifentanil at 3-5 μg/L. The two groups were operated under local anesthesia. The Ramsay score, MAP, and SpO2 were observed at baseline time (T0), anesthesia induction (T1), skin cut (T2), and accomplishment of surgery (T3).ResultsThe Ramsay scores of the experimental group were lower than those of the control group at T0, T1, T2, and T3 ［T0: (1.8±0.4) points vs. (2.1±0.6) points, t=2.664, P=0.009; T1: (2.8±0.3) points vs. (5.1±0.4) points, t=29.454, P=0.000; T2: (3.0±0.5) points vs. (4.8±0.3) points, t=19.766, P=0.000; T3: (2.9±0.4) points vs. (3.9±0.6) points, t=8.880, P=0.000］. The MAP of the experimental group was higher than that of the control group at T1 ［(76.2±10.1) mm Hg vs. (67.2±11.4) mm Hg, t=-3.784, P=0.002］,and there was no significant difference at other timepoints between the two groups(P>0.05). The SpO2 of the experimental group at T0, T1, and T2 were higher than those of the control group ［T0: (96.0±1.0)% vs. (95.0±1.5)%, t=-3.552, P=0.000; T1: (95.5±1.1)% vs. (90.0±15)%, t=-18.933, P=0.000; T2: (95.0±1.3)% vs. (90.8±11)%, t=-15.792, P=0.000］.There was no significant difference in SpO2 at T3 between the two groups(t=0.220,P=0.827).ConclusionDexmedetomidine can be used safely in aortic dissection stent graft exclusion.

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备注/Memo

备注/Memo:
基金项目：河南省洛阳市科技攻关项目（1503006A-2）； 河南省医学科学科技攻关计划项目（201602360）**通讯作者，E-mail：13721624858@163.com①心外科
更新日期/Last Update: 2018-03-21