[1]牟洪颖,王海云,肖军章,等.右美托咪定在保护性通气下对腹腔镜全子宫切除手术患者肺功能的影响[J].医学信息,2020,33(11):91-94.[doi:10.3969/j.issn.1006-1959.2020.11.026]
　MOU Hong-ying,WANG Hai-yun,XIAO Jun-zhang,et al.Effects of Dexmedetomidine on Lung Function in Patients Undergoing Laparoscopic Hysterectomy Under Protective Ventilation[J].Medical Information,2020,33(11):91-94.[doi:10.3969/j.issn.1006-1959.2020.11.026]
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右美托咪定在保护性通气下对腹腔镜全子宫切除手术患者肺功能的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年11期
页码:
91-94
栏目:
综述
出版日期:
2020-06-01

文章信息/Info

Title:
Effects of Dexmedetomidine on Lung Function in Patients Undergoing Laparoscopic Hysterectomy Under Protective Ventilation
文章编号:
1006-1959（2020）11-0091-04
作者:
牟洪颖; 王海云; 肖军章; 等
（1.天津医科大学三中心临床学院，天津 300170；2.天津市重症疾病体外生命支持重点实验室/天津市人工细胞工程技术研究中心/天津市肝胆研究所，天津 300170；3.天津市第三中心医院麻醉科，天津 300170；4.天津市蓟州区人民医院麻醉科，天津 301900）
Author(s):
MOU Hong-ying; WANG Hai-yun; XIAO Jun-zhang; et al
(1.Three Centers Clinical College,Tianjin Medical University,Tianjin 300170,China;2.Tianjin Key Laboratory of In Vitro Life Support for Severe Diseases/Tianjin Artificial Cell Engineering Research Center/Tianjin Hepatobiliary Research Institute,Tianjin 300170,China3.Department of Anesthesiology,Tianjin Third Central Hospital,Tianjin 300170,China;4.Department of Anesthesiology,Tianjin Jizhou District People’s Hospital,Tianjin 301900,China)
关键词:
右美托咪定; 腹腔镜手术; 呼吸力学; 拔管时间
Keywords:
Dexmedetomidine; Laparoscopic surgery; Respiratory mechanics; Extubation time
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2020.11.026
文献标志码:
A
摘要:
目的 探讨右美托咪定在保护性通气下对腹腔镜全子宫切除手术患者肺功能的影响。方法 选取2018年3~12月于天津市蓟州区人民医院择期全身麻醉下行腹腔镜全子宫切除手术患者60例，按照随机数字表法将其分为对照组（C组）和右美托咪定组（D组），每组30例。麻醉前两组均给予阿托品，D组于麻醉诱导前15 min经静脉泵注右美托咪定，C组给予泵注等容量生理盐水，比较两组气管插管后5 min（T1）、关气腹前即刻（T2）、气腹结束后5 min（T3）时气道峰压（Ppeak）、平均气道压（Pmean）、气道平台压（Pplat）、呼气末正压（PEEP）及动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、驱动压（DP）、氧合指数（PaO2/FiO2）、呼吸指数（RI）、死腔通气率（VD/VT）、肺泡-动脉血氧分压差（A-aDO2），记录拔除气管导管时间。结果 与C组比较，D组T1~T3时Ppeak、Pmean、DP、RI、VD/VT和A-aDO2均降低，PaO2/FiO2升高（P＜0.05）；与T1时比较，C组和D组T2时Ppeak、Pmean、DP、RI、VD/VT和A-aDO2均升高，PaO2/FiO2降低（P＜0.05）。C组拔管时间为（13.00±1.94）min，与D组的（12.03±2.30）min比较，差异无统计学意义（P＞0.05）。结论 右美托咪定在保护性通气基础上可进一步改善腹腔镜全子宫切除术患者呼吸力学和肺换气功能，从而发挥肺保护作用，且不影响拔管时间。
Abstract:
Objective To investigate the effect of dexmedetomidine on lung function in patients undergoing laparoscopic hysterectomy under protective ventilation.Methods 60 patients underwent laparoscopic hysterectomy under general anesthesia in Tianjin Jizhou District People’s Hospital from March to December 2018 were selected and divided into a control group (group C) and dexmedetomidine according to random number table Group (Group D), 30 cases in each group. Both groups were given atropine before anesthesia, group D was given intravenous dexmedetomidine 15 minutes before anesthesia induction, group C was given an equal volume of saline, and the two groups were compared 5 min after tracheal intubation (T1),Peak airway pressure (Ppeak), mean airway pressure (Pmean), airway platform pressure (Pplat), positive end-expiratory pressure (PEEP) immediately before closing the pneumoperitoneum (T2), 5 min after the end of the pneumoperitoneum (T3)and arterial blood oxygen partial pressure (PaO2), arterial blood carbon dioxide partial pressure (PaCO2), driving pressure (DP), oxygenation index (PaO2/FiO2), respiratory index (RI), dead space ventilation rate (VD/VT), Alveolar-arterial blood oxygen partial pressure difference (A-aDO2), record the time of tracheal tube removal.Results Compared with group C, Ppeak, Pmean, DP, RI, VD/VT and A-aDO2 all decreased in groups D from T1 to T3, and PaO2/FiO2 increased (P<0.05); compared with group T1, groups C and D at T2, Ppeak, Pmean, DP, RI, VD/VT and A-aDO2 all increased, and PaO2/FiO2 decreased (P<0.05).The extubation time of group C was (13.00±1.94) min,compared with (12.03±2.30) min of group D, the difference was not statistically significant (P>0.05).Conclusion Dexmedetomidine can further improve the respiratory mechanics and lung ventilation function of patients undergoing laparoscopic hysterectomy on the basis of protective ventilation, so as to exert the lung protective effect without affecting the extubation time.

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