| 李树武,侯 杰,李晓锋,范明威,任 瑜,李铁成.顺阿曲库铵与右美托咪定在腹腔镜全子宫切除术中的效果及对ATⅢ、D-D、FDP、Cor的影响[J].,2018,(6):1176-1180 |
| 顺阿曲库铵与右美托咪定在腹腔镜全子宫切除术中的效果及对ATⅢ、D-D、FDP、Cor的影响 |
| Comparison of Clinical Efficacy of Cisatriptan and Dexmedetomidine in Laparoscopic Hysterectomy and Effect on Serum ATⅢ, D-D, FDP and Cortisol Levels |
| 投稿时间：2017-06-07 修订日期：2017-06-30 |
| DOI：10.13241/j.cnki.pmb.2018.06.038 |
| 中文关键词: 顺阿曲库铵 右美托咪定 全子宫切除术 |
| 英文关键词: Cisatriptan Dexmedetomidine Total hysterectomy |
| 基金项目:辽宁省自然科学基金项目(20102282) |
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| 中文摘要: |
| 摘要 目的：研究顺阿曲库铵与右美托咪定在腹腔镜全子宫切除术中的效果及对抗凝血酶III(AT III)、D-二聚体(D-D)、纤维蛋白降解产物(FDP)、皮质醇(Cor)的影响。方法：选取2014年8月至2015年7月在我院行腹腔镜全子宫切除术的86例患者，根据患者入院顺序分为观察组和对照组，42例每组。对照组经顺阿曲库铵完成麻醉，观察组经右美托咪定完成麻醉。比较两组患者生命体征，麻醉相关指标，镇痛镇静效果，血清ATⅢ、D-D、FDP、Cor水平及不良反应的发生情况。结果：拔管后1 min，两组患者动脉氧分压、氧饱和度与麻醉前相比差异无统计学意义(P>0.05)，心率、平均脉压水平较麻醉前显著升高(P<0.05)，和对照组相比，观察组心率、平均脉压水平较低(P<0.05)。观察组拔管时间、自主呼吸恢复时间显著短于对照组(P<0.05)，两组患者苏醒时间比较无显著差异(P>0.05)。两组术后2 h、12 h、24 h的Ramsay评分、VAS评分在组间、不同时点间、组间不同时点间交互效应比较差异有统计学意义(P<0.05)，两组术后2 h、12 h、24 h的Ramsay评分均呈上升趋势，观察组始终高于对照组，两组术后2 h、12 h、24 h的VAS评分均呈下降趋势，观察组始终低于对照组，差异有统计学意义(P＜0.05)。观察组寒战、呕吐、恶心、眩晕不良反应率显著低于对照组(P<0.05)。结论：相对于顺阿曲库铵，在腹腔镜全子宫切除术中应用右美托咪定更能有效稳定患者血清ATⅢ、D-D、FDP、Cor水平，镇痛镇静效果良好，安全性高。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the clinical efficacy of cisatriptan and dexmedetomidine in the laparoscopic hysterectomy and the effect on the serum antithrombin III (AT III), D-dimer (DD), fibrin degradation Product (FDP), cortisol (Cor) levels. Methods: From August 2014 to July 2015, 86 cases of patients underwent laparoscopic hysterectomy in our hospital were divided into the observation group and the control group according to the order of admission. The control group was treated with triptolide, and the observation group was treated with dexmedetomidine. The vital signs, anesthesia-related indicators, analgesic sedation, serum ATⅢ, D-D, FDP, Cor levels and incidence of adverse reactions were compared between two groups. Results: At 1 min after extubation, compared with anesthesia, there was no significant difference in arterial oxygen partial pressure and oxygen saturation between the two groups (P> 0.05). The heart rate and mean pulse pressure were significantly higher than those before anesthesia (P <0.05). Compared with the control group, the heart rate and mean pulse pressure of the observation group were lower (P <0.05). The duration of extubation and spontaneous respiration were significantly shorter in the observation group than those in the control group (P <0.05), there was no significant difference in the awakening time between the two groups (P> 0.05). There was significant difference in the Ramsay score and VAS score between the two groups at 2h, 12h and 24h after operation (P <0.05). The difference between the two groups was statistically significant (P <0.05). The Ramsay scores of the two groups were higher than those of the control group. The VAS scores of the two groups were lower than those of the control group at 2h, 12h and 24h respectively. The observation group was always lower than the control group (P <0.05). There was significant difference between different time points, between groups and between different time points (P <0.05). The adverse reactions rate of chills, vomiting, nausea and vertigo in the observation group were significantly lower than those in the control group (P <0.05). Conclusion: Compared with cisatriptan, dexmedetomidine can more effectively stabilize the serum AT Ⅲ, D-D, FDP, Cor levels with good analgesic sedative effect is good and high safety in the laparoscopic hysterectomy. |
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