本文選題：右美托咪定　切入點：氣腹　出處：《蘇州大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：觀察使用右美托咪定（dexmedetomidine，Dex）在婦科腹腔鏡手術(shù)中對機體應(yīng)激反應(yīng)的影響。 方法：選擇40例擇期婦科腔鏡手術(shù)患者，ASAI～II級，年齡20～65歲，體重45～70kg�；颊唠S機分為兩組,每組20例(n=20)。D組(右美托咪定負荷組)在麻醉誘導(dǎo)前給予右美托咪定負荷量0.8μg.kg-1靜脈泵注10min，然后以咪達唑侖、芬太尼、異丙酚、順式阿曲庫銨進行麻醉誘導(dǎo)；C組（對照組）在誘導(dǎo)前給予等容量的生理鹽水泵注,麻醉誘導(dǎo)同D組；兩組患者術(shù)中給予芬太尼、丙泊酚、順式阿曲庫銨、七氟醚維持麻醉。記錄兩組患者血流動力學(xué)及麻醉藥的用量，，并在麻醉誘導(dǎo)前(T1)、氣管插管前(T2)、手術(shù)開始時(T3)、氣腹15min(T4)、氣腹30min(T5)、手術(shù)后24h(T6)時檢測患者血中促腎上腺皮質(zhì)激素（adrenocorticotropic hormone，ACTH）、皮質(zhì)醇（cortisl，Cor）、兒茶酚胺（catecholamin，CA）、抗利尿激素(antidiuretichormone，ADH)以及醛固酮(aldosterone, ALD)的含量。其中ACTH及Cor采用電化學(xué)發(fā)光免疫分析法、CA以及ADH采用ELISA法、ALD采用γ-放射免疫法。 結(jié)果： 與D組相比， C組患者T1、 T2、 T6時間點的血ACTH、Cor、CA、ADH、ALD無明顯差異（P㧐0.05）；而T3、T4、T5時間點的血ACTH、Cor、CA、ADH、ALD顯著高于D組，二者差異有統(tǒng)計學(xué)意義（P＜0.05）。與D組相比，C組患者T1、T2、T6時間點的心率、血壓變化無明顯差異（P㧐0.05），而T3、T4、T5時間點的C組患者心率、血壓變化明顯增大，二者差異有統(tǒng)計學(xué)意義（P＜0.05）。 結(jié)論：婦科腔鏡手術(shù)中應(yīng)用Dex能明顯減少應(yīng)激激素血ACTH、Cor、CA、ADH、ALD的釋放，并能有效穩(wěn)定血流動力學(xué),使患者術(shù)中生命體征更平穩(wěn)。Dex是較好的全身麻醉輔助用藥。
[Abstract]:Objective: To observe the effect of dexmedetomidine (Dex) on the stress response of the body during gynecologic laparoscopy.
Methods: 40 cases of patients undergoing gynecological laparoscopic surgery patients, ASAI ~ II, age 20~65 years old, weighing 45 ~ 70kg. were randomly divided into two groups, 20 cases in each group (n=20) and.D group (dexmedetomidine loading group) received dexmedetomidine loading 0.8 g.kg-1 intravenous infusion of 10min in induction of anesthesia before then, with midazolam, fentanyl, propofol and cisatracurium anesthesia; group C (control group) was given before the induction of saline infusion volume, induction of anesthesia with D group; the two groups of patients treated with fentanyl, propofol and cisatracurium, sevoflurane record two groups of patients with anesthesia. The hemodynamics and anesthetic dosage, and before induction of anesthesia (T1), before intubation (T2), at the beginning of the operation (T3), 15min pneumoperitoneum (T4), 30min pneumoperitoneum (T5), 24h after operation (T6) ACTH test in patients with (adrenocorticotropic hormone, ACTH), Cortisl (Cor), catecholamine (catecholamin, CA), antidiuretic hormone (antidiuretichormone, ADH) and aldosterone (aldosterone, ALD) content. ACTH and Cor were analyzed by electrochemiluminescent immunoassay, CA and Cor were used by gamma method, and gamma ray radioimmunoassay was used.
Result錛

本文編號：1569830