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右美托咪定在亲属活体肾移植受体手术麻醉中的应用

魏昕 周素素 高玮 毛佳丽 疏树华 柴小青

魏昕, 周素素, 高玮, 等. 右美托咪定在亲属活体肾移植受体手术麻醉中的应用[J]. 器官移植, 2015, 6(6): 410-414. doi: 10.3969/j.issn.1674-7445.2015.06.013
引用本文: 魏昕, 周素素, 高玮, 等. 右美托咪定在亲属活体肾移植受体手术麻醉中的应用[J]. 器官移植, 2015, 6(6): 410-414. doi: 10.3969/j.issn.1674-7445.2015.06.013
Wei Xin, Zhou Susu, Gao Wei, et al. Application of dexmedetomidine in anesthesia for recipients in living related renal transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 410-414. doi: 10.3969/j.issn.1674-7445.2015.06.013
Citation: Wei Xin, Zhou Susu, Gao Wei, et al. Application of dexmedetomidine in anesthesia for recipients in living related renal transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 410-414. doi: 10.3969/j.issn.1674-7445.2015.06.013

右美托咪定在亲属活体肾移植受体手术麻醉中的应用

doi: 10.3969/j.issn.1674-7445.2015.06.013
基金项目: 

国家自然科学青年基金项目 81300970

安徽省自然科学基金项目 1408085MH186

详细信息
    通讯作者:

    魏昕, Email:kekaiyuan628@126.com

  • 中图分类号: R617;R657.3

Application of dexmedetomidine in anesthesia for recipients in living related renal transplantation

More Information
  • 摘要:   目的  评价右美托咪定(Dex)应用于亲属活体肾移植终末期肾病(ESRD)受体手术麻醉的有效性与安全性。  方法  2013年10月至2014年12月在安徽医科大学附属省立医院行亲属活体肾移植的ESRD患者40例, 随机分为Dex组及对照组各20例。Dex组于麻醉诱导前给予Dex 0.6 μg/kg的负荷剂量, 于20 min内泵注完毕, 继以0.2 μg/(kg·h)泵注1 h结束后随即行全身麻醉诱导; 对照组泵注等量的生理盐水, 两组的麻醉诱导及维持药物相同。观察并记录两组患者用药前(T0), 用药后20 min (T1)以及置入喉罩前(T2)、置入喉罩后(T3)各时点的平均动脉压、心率及脑电双频指数(BIS); 观察有否苏醒延迟, 苏醒期躁动情况。记录术中、术后(4、8、12、24 h)尿量以及术前、术后(12、24 h)内生肌酐清除率。  结果  与T0比较, 两组患者T2的平均动脉压、心率及BIS值均明显下降(均为P < 0.05), 两组间比较, Dex组心率、BIS下降更为明显(均为P < 0.05), 但平均动脉压无明显下降(P>0.05)。Dex组苏醒期躁动的发生率为15%(3/20), 均为轻度躁动, 与对照组(30%, 6/20)比较明显下降(P < 0.05)。Dex组术中、术后4 h及8 h尿量均较相应时间的对照组明显增多(均为P < 0.05)。两组患者术后12 h及24 h内生肌酐清除率均较术前明显上升(均为P < 0.01)。  结论  右美托咪定可降低亲属活体肾移植受体苏醒期躁动发生率, 增加术后尿量, 无发生苏醒延迟, 可安全用于ESRD患者。

     

  • 表  1  两组患者用药及置入喉罩前后心率、平均动脉压及脑电双频指数值比较

    Table  1.   Comparison of heart rate, mean arterial pressure and bispectral index before and after administration ad laryngeal mask intubation between two groups (x±s)

    指标 n T0 T1 T2 T3
    心率(次/分)
    Dex组 20 89±18 69±14a, b 65±10a, b 64±9b
    对照组 20 83±9 88±13 75±5b 72±6b
    平均动脉压(mmHg)
    Dex组 20 123±13 116±10 98±12b 101±10b
    对照组 20 127±12 129±11 101±9b 96±10b
    BIS
    Dex组 20 97.8±0.7 85.3±2.7a, b 50.2±6.2b 45.6±5.0b
    对照组 20 97.9±0.8 97.8±0.8 48.2±4.3b 45.8±3.1b
    注:与对照组比较,aP < 0.05;与T0比较,bP < 0.05;10 mmHg=1.33 kPa
    下载: 导出CSV

    表  2  两组患者术后尿量及内生肌酐清除率变化比较

    Table  2.   Comparison of urine output and endogenous creatinine clearance rate after operation between two groups(x±s)

    组别 n 尿量(ml/kg) 内生肌酐清除率(ml/min)
    术中 术后4 h 术后8 h 术后12 h 术后24 h 术前 术后12 h 术后24 h
    Dex组 20 31±7a 98±26a 195±20a 260±44 450±20 7.1±1.4 67.0±6.2b 101.0±16.0b
    对照组 20 25±4 79±10 169±18 259±54 430±36 7.8±2.1 59.0±5.0b 99.0±18.0b
    注:与对照组比较,aP < 0.05;与术前比较,bP < 0.05
    下载: 导出CSV
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出版历程
  • 收稿日期:  2015-08-01
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2015-11-15

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