余露++盛良

[摘要] 目的 对预注右旋美托咪啶用于喉显微手术麻醉的临床效果进行研究及判定。 方法 方便选取该院2014年1月—2016年12月收治的100例喉显微手术患者作为该次研究对象，将其分为对照组与观察组，对照组50例，观察组50例，对照组予以芬太尼、丙泊酚联合麻醉，观察组于麻醉诱导前予以盐酸右旋美托咪啶预注，之后予以芬太尼、丙泊酚联合麻醉，并观察2组患者的T0、T1、T2、T3点血流动力学情况、术后拔管时间、术后清醒时间及不良反应发生率。结果 观察组患者T0、T1、T2、T3动力学指标均优于对照组（P<0.05），且术后拔管时间为（33.82±10.02）min，术后苏醒时间为（18.32±10.12）min，不良反应发生率为3.45%，低于对照组（P<0.05）。 结论 于喉显微手术麻醉前予以右旋美托咪啶预注，可稳定患者血流动力学，缓解其应激反应，促使患者术后恢复，且不良反应较少，效果显著，值得在临床中推广实施。

[关键词] 盐酸右旋美托咪啶；预注；喉显微手术；麻醉

[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0132-03

[Abstract] Objective To research and determine the clinical effect of priming of dextroamphetamine in the anesthesia of microlaryngosurgery. Methods 100 cases of patients with microlaryngosurgery admitted and treated in our hospital from January 2014 to December 2016 were convenient selected and divided into two groups with 50 cases in each， the control group adopted the combined anesthesia of fentanyl and propofol， while the observation group were given the priming of dexmedetomidine hydrochloride before the induction of anesthesia and then were given the combined anesthesia of fentanyl and propofol， and the hemodynamics at T0，T1，T2，T3， postoperative tube drawing time， postoperative awakening time and incidence rate of adverse reactions of the two groups were observed. Results The hemodynamics indexes at T0， T1， T2， T3 in the observation group were better than those in the control group（P<0.05）， and the postoperative tube drawing time， postoperative awakening time and incidence rate of adverse reactions in the observation group were respectively （33.82±10.02） min， （18.32±10.12） min and 3.45%， which were lower than those in the control group（P<0.05）. Conclusion The priming of dextroamphetamine in the anesthesia of microlaryngosurgery can stabilize the hemodynamics of patients， relieve their stress reactions and promote the postoperative recovery with fewer adverse reactions and obvious effect， which is worth clinical promotion and implementation.

[Key words] Dexmedetomidine hydrochloride； Priming； Microlaryngosurgery； Anesthesia

喉顯微手术具有麻醉深度适宜、手术野清晰等优势[1]，该术式手术时间较短，故术后患者苏醒时间越短，则表示安全性越高[2]，但该手术为静脉麻醉，其静脉麻醉易引起心脑血管类不良反应。右旋美托咪啶为肾上腺素受体激动类药物，具有强效的交感神经抑制及麻醉作用。该研究于2014年1月—2016年12月收治的50例患者于喉显微手术麻醉前予以右旋美托咪啶预注治疗获得较好的效果，现报道如下。

1 资料与方法

1.1 一般资料

该研究经该院伦理委员会通过并执行，方便选取该院收治的100例喉显微手术患者作为该次研究对象，将其分为对照组与观察组，对照组50例，观察组50例，具体如下：纳入标准：①经各项实验检测，其结果符合喉显微手术条件者；②具有完好的临床资料者；③年龄<90岁者；④对麻醉药品耐受者；……