本文選題：右美托咪定 + 全麻�。� 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：背景及目的：全身麻醉蘇醒期間部分患者因各種刺激因素發(fā)生術(shù)后躁動(dòng)（postoperative agitation）和（或）咽喉疼痛（throat pain）。程度嚴(yán)重時(shí)可對(duì)患者造成重大傷害。右美托咪啶（Dexmedetomidine，Dex）為新型、高選擇性α2-腎上腺素能受體（α2AR）激動(dòng)劑,具有劑量依賴性鎮(zhèn)靜、鎮(zhèn)痛、抗焦慮、抑制交感神經(jīng)及腦保護(hù)等多種作用,無呼吸抑制,可通過激動(dòng)中樞神經(jīng)系統(tǒng)α2受體最密集的區(qū)域——腦干藍(lán)斑核（Locus Coeruleus）(負(fù)責(zé)調(diào)解覺醒與睡眠),引發(fā)并維持自然非動(dòng)眼睡眠(NREM)狀態(tài),類似生理睡眠易喚醒,副作用少而輕。本研究擬通對(duì)照分組實(shí)驗(yàn)，分析右美托咪定在預(yù)防全麻術(shù)后躁動(dòng)和咽喉疼痛方面的效果，為提高全身麻醉的安全性及舒適性提供參考及依據(jù)。 方法：選取在上海市第八人民醫(yī)院自2013年6月至2013年12月，接受氣管插管全麻擬行腹部以下手術(shù)治療的患者114例，通過隨機(jī)數(shù)字表法將其分為觀察組和對(duì)照組各57例。兩組均采用相同的藥物進(jìn)行全身麻醉，觀察組在手術(shù)結(jié)束前半個(gè)小時(shí)靜脈泵入右美托咪定，對(duì)照組則靜脈泵入相同體積的0.9%氯化鈉注射液。對(duì)比兩組患者恢復(fù)自主呼吸的時(shí)間和拔除氣管插管時(shí)間以及術(shù)后躁動(dòng)和咽喉疼痛的發(fā)生率。采用t檢驗(yàn)、卡方檢驗(yàn)對(duì)研究資料統(tǒng)計(jì)分析。 結(jié)果：兩組患者恢復(fù)自主呼吸時(shí)間、拔除氣管插管時(shí)間的對(duì)比，差異沒有統(tǒng)計(jì)學(xué)意義（P＞0.05）。在術(shù)后躁動(dòng)方面，觀察組0級(jí)的有53例，躁動(dòng)率為7.02%；對(duì)照組0級(jí)的有34例，躁動(dòng)率為40.35%。觀察組躁動(dòng)率顯著低于對(duì)照組（P＜0.05）。在術(shù)后咽喉疼痛方面，觀察組0級(jí)的有46例，咽喉疼痛率為19.30%；對(duì)照組0級(jí)的有30例，咽喉疼痛率為47.37%。觀察組咽喉疼痛率率顯著低于對(duì)照組（P＜0.05）。 結(jié)論：右美托咪定對(duì)全麻術(shù)后躁動(dòng)和咽喉疼痛具有良好的預(yù)防作用，同時(shí)不會(huì)呼吸抑制和延遲蘇醒，值得在臨床上推廣應(yīng)用。
[Abstract]:Background and objective: during general anaesthesia, some patients were restless postoperatively and / or throat pain due to various stimuli. Severe injuries can be caused to patients. Dexmedetomine Dexine is a novel and highly selective 偽 _ 2-adrenergic receptor (偽 _ 2ARR) agonist with dose-dependent sedation, analgesia, anti-anxiety, inhibition of sympathetic nerve and brain protection, and no respiratory inhibition. Locus Coeruleusus, the most dense area of 偽 _ 2 receptor in the central nervous system, is responsible for regulating arousal and sleep, causing and maintaining NREM, which is similar to physiological sleep, which is easy to awaken and has less side effects. The purpose of this study was to analyze the effect of dexmetomidine on the prevention of restlessness and larynx pain after general anesthesia in order to improve the safety and comfort of general anesthesia. Methods: from June 2013 to December 2013, 114 patients undergoing tracheal intubation under general anesthesia were selected and randomly divided into two groups: observation group (n = 57) and control group (n = 57). The two groups were anesthetized with the same drugs. The observation group received dexmetomidine half an hour before the end of operation, while the control group received 0.9% sodium chloride injection in the same volume. The time of spontaneous respiration, tracheal intubation and postoperative restlessness and larynx pain were compared between the two groups. T test and chi-square test were used to analyze the research data. Results: there was no significant difference in the time of spontaneous respiration and tracheal intubation between the two groups (P > 0.05). In terms of postoperative restlessness, there were 53 cases in the observation group (grade 0) and 34 cases in the control group (grade 0) with the restlessness rate of 7.02%, and the restlessness rate was 40.35% in the control group. The restlessness rate in the observation group was significantly lower than that in the control group (P < 0.05). In terms of postoperative laryngeal pain, there were 46 cases in the observation group with grade 0 and 19.30% in the control group, and 30 cases in the control group with a pain rate of 47.37. The rate of throat pain in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: dexmetomidine has a good preventive effect on restlessness and laryngopharyngeal pain after general anesthesia without respiratory inhibition and delayed recovery. It is worth popularizing in clinic.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 林森;楊承;王漢兵;劉洪珍;;右美托咪定在硬膜外自控鎮(zhèn)痛中的應(yīng)用[J];廣東醫(yī)學(xué);2012年04期

2 鄭耀明;瞿波;于永群;陳旭華;容穎雅;胡勝英;方銳倫;;右美托咪定在纖維光導(dǎo)喉鏡引導(dǎo)清醒氣管插管中的應(yīng)用[J];廣東醫(yī)學(xué);2012年08期

3 黃瑞云;宣慶;陳海明;;全麻術(shù)后躁動(dòng)原因分析與處理方法探討[J];廣西醫(yī)學(xué);2010年07期

4 劉晶;廖信芳;胡祖榮;賈杰;黃希照;鄧戀;;右美托咪定預(yù)防全麻術(shù)后躁動(dòng)和咽喉疼痛的作用[J];廣東醫(yī)學(xué);2012年19期

5 袁婉秋;施小彤;沈浩林;陳夢(mèng);;右美托咪定用于經(jīng)鼻盲探氣管插管的效果[J];廣東醫(yī)學(xué);2013年04期

6 柴小青;方才;;氟比洛芬酯預(yù)防/減少全麻術(shù)后躁動(dòng)與咽喉疼痛的臨床觀察[J];臨床麻醉學(xué)雜志;2006年11期

7 鮑楊;史東平;封衛(wèi)征;;全麻蘇醒期患者躁動(dòng)的研究進(jìn)展[J];臨床麻醉學(xué)雜志;2010年02期

8 朱焱林;肖洪波;;小兒七氟醚麻醉蘇醒期間躁動(dòng)的研究[J];臨床麻醉學(xué)雜志;2010年11期

9 陶佳;顧小萍;彭良玉;張偉;業(yè)光衡;馬正良;;右美托咪定預(yù)先給藥對(duì)術(shù)后疼痛及瑞芬太尼痛覺過敏的影響[J];臨床麻醉學(xué)雜志;2011年10期

10 斯妍娜;韓流;王曉亮;王宏宇;蘇中宏;鮑紅光;;右美托咪定對(duì)術(shù)后嗎啡自控鎮(zhèn)痛效果的影響[J];臨床麻醉學(xué)雜志;2011年10期

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