右美托咪定在內鏡黏膜下剝離術中的應用

俞峰　孫衛東　鄭永志

【摘要】 目的：探討右美托咪定在內鏡黏膜下剝離術中的應用價值。方法：129例擬行內鏡黏膜下剝離術的患者，采用隨機數字表法平均分為三組，對照組（A組）采用單用丙泊酚麻醉，研究組（B組）采用右美托咪定[0.2 ?g/（kg·h）]復合丙泊酚麻醉，研究組（C組）采用右美托咪定[0.3 ?g/（kg·h）]

復合丙泊酚麻醉。術后評估麻醉效果，比較麻醉時間、手術時間及蘇醒時間，各組的丙泊酚用量，以及不良反應發生情況等。結果：與A組比較，研究組的麻醉效果較優（P<0.05），但B組、C組間比較差異無統計學意義（P>0.05）;各組患者麻醉時間、手術時間比較差異無統計學意義（P>0.05）;研究組C組的蘇醒時間明顯長于A組和B組（P<0.05），同時A組和B組的蘇醒時間相比差異無統計學意義（P>0.05）;與A組比較，研究組的丙泊酚用量顯著低于對照組（P<0.05），但B組、C組比較差異無統計學意義（P>0.05）;B組不良反應發生率最低（P<0.05）。結論：在內鏡黏膜下剝離術中采用右美托咪定[0.2 ?g/（kg·h）]復合丙泊酚的麻醉方式，可以為手術操作提供理想的麻醉效果，減少丙泊酚用量，減少不良反應，是安全有效的麻醉方法。

【關鍵詞】 右美托咪定; 丙泊酚; 麻醉; 內鏡黏膜下剝離術

doi：10.14033/j.cnki.cfmr.2019.05.011 文獻標識碼 B 文章編號 1674-6805（2019）05-00-03

Application of Dexmedetomidine in Patients Undergoing Endoscopic Submucosal Dissection/YU Feng，SUN Weidong，ZHENG Yongzhi.//Chinese and Foreign Medical Research，2019，17（5）：-27

【Abstract】 Objective：To investigate the application of Dexmedetomidine in patients undergoing endoscopic submucosal dissection（ESD）.Method：129 patients in need of ESD in our hospital were selected.They were randomly divided into control group A（injected with only Propofol），study group B[injected with Propofol and low-dose Dexmedetomidine 0.2 ?g/（kg·h）] and study group C[injected with Propofol and low-dose Dexmedetomidine 0.3 ?g/（kg·h）].The analgesia effects，analgesia time，operative time，wake up time，the dose of propofol and adverse reactions were recorded in the 24 h after the treatment.Result：Compared with group A，the analgesia effects in group B and group C were better with statistically significant（P<0.05）.However there was no statistically significant differences between group B and group C（P>0.05）.Compared with group C，the wake up time in group A and group B were longer with statistically significant（P<0.05）.However there was no statistically significant differences between group A and group B（P>0.05）.There was no significant difference in analgesia time and operative time（P>0.05）.The wake up time of group C was significantly longer than that of group A and group B（P<0.05），and there was no significant difference between group A and group B（P>0.05）.Compared with group A，the dose of Propofol in group B，group C were lower with statistically significant（P<0.05）.However there was no statistically significant differences between group B and group C（P>0.05）.The adverse reactions in group B were significantly lower than that in group A and group C（P<0.05）.Conclusion：The application of Propofol and low-dose Dexmedetomidine[2 ?g/（kg·h）] is safe and effective in patients undergoing endoscopic submucosal dissection.It also can reduce the the dose of Propofol and improve the satisfaction of patients.