右美托咪定在内镜黏膜下剥离术中的应用

俞峰　孙卫东　郑永志

【摘要】 目的：探討右美托咪定在内镜黏膜下剥离术中的应用价值。方法：129例拟行内镜黏膜下剥离术的患者，采用随机数字表法平均分为三组，对照组（A组）采用单用丙泊酚麻醉，研究组（B组）采用右美托咪定[0.2 ?g/（kg·h）]复合丙泊酚麻醉，研究组（C组）采用右美托咪定[0.3 ?g/（kg·h）]

复合丙泊酚麻醉。术后评估麻醉效果，比较麻醉时间、手术时间及苏醒时间，各组的丙泊酚用量，以及不良反应发生情况等。结果：与A组比较，研究组的麻醉效果较优（P<0.05），但B组、C组间比较差异无统计学意义（P>0.05）;各组患者麻醉时间、手术时间比较差异无统计学意义（P>0.05）;研究组C组的苏醒时间明显长于A组和B组（P<0.05），同时A组和B组的苏醒时间相比差异无统计学意义（P>0.05）;与A组比较，研究组的丙泊酚用量显著低于对照组（P<0.05），但B组、C组比较差异无统计学意义（P>0.05）;B组不良反应发生率最低（P<0.05）。结论：在内镜黏膜下剥离术中采用右美托咪定[0.2 ?g/（kg·h）]复合丙泊酚的麻醉方式，可以为手术操作提供理想的麻醉效果，减少丙泊酚用量，减少不良反应，是安全有效的麻醉方法。

【关键词】 右美托咪定; 丙泊酚; 麻醉; 内镜黏膜下剥离术

doi：10.14033/j.cnki.cfmr.2019.05.011 文献标识码 B 文章编号 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.