邓海泽

【摘要】 目的：研究右美托咪定静脉泵注联合七氟烷吸入麻醉在宫腔镜电切术中的效果。方法：选取2018年1-12月于本院进行宫腔镜电切术的62例患者，按随机数字表法分为试验组和对照组，每组31例。对照组给予七氟烷吸入麻醉，试验组在对照组基础上给予右美托咪定静脉泵注。比较两组患者在麻醉前（T0）、术中（T1）、术后清醒（T2）、清醒后10 min（T3）四个时间节点的血流动力学（心率、平均动脉压、呼吸频率、血氧饱和度）。比较两组Ramsay评分、警觉/镇静观察评分、疼痛评分及不良反应。结果：试验组T1、T2、T3心率和T1呼吸频率均低于对照组（P<0.05）。试验组Ramsay评分与警觉/镇静观察评分均高于对照组（P<0.05），而试验组疼痛评分低于对照组（P<0.05）。试验组不良反应发生率明显低于对照组（P<0.05）。结论：右美托咪定静脉泵注联合七氟烷吸入麻醉在宫腔镜电切术中的麻醉效果显著，可维持血流动力学的稳定，具有较强的镇痛、镇静作用且安全有效。

【关键词】 右美托咪定; 七氟烷; 宫腔镜电切术

【Abstract】 Objective：To study the effect of Dexmedetomidine intravenous pumping combined with Sevoflurane inhalation anesthesia in hysteroscopic electric resection.Method：62 patients underwent hysteroscopic electric resection in our hospital from January to December 2018 were divided into experimental group and control group according to the random number table method，31 cases in each group.The control group was given anesthesia with Sevoflurane inhalation.The experimental group was given intravenous injection of Dexmedetomidine on the basis of the control group.The hemodynamics（heart rate，mean arterial pressure，respiratory rate，oxygen saturation） of the two groups at four time points for before anesthesia（T0），intraoperative（T1），postoperative awake（T2） and awake 10 min（T3） were compared.The Ramsay score，alert/sedation observation score，pain score and adverse reactions were compared between the two groups.Result：The T1，T2，T3 heart rate and T1 respiratory rate of the experimental group were lower than those of the control group（P<0.05）.The Ramsay score and alertness/sedation score of the experimental group were higher than those in the control group （P<0.05）.While the pain score of the experimental group was lower than that of the control group（P<0.05）.The incidence of adverse reactions was significantly lower than the control group（P<0.05）.Conclusion：The Dexmedetomidine intravenous pumping combined with Sevoflurane inhalation anesthesia has significant anesthetic effect in hysteroscopic electric resection，it can maintain hemodynamic stability，has strong analgesic and sedative effects，it is safe and effective.

【Key words】 Dexmedetomidine; Sevoflurane; Hysteroscopic electric resection

First-authors address：The Sixth Peoples Hospital of Huizhou，Huizhou 516211，China

doi：10.3969/j.issn.1674-4985.2019.17.006

隨着社会的不断发展，宫腔镜电切术因具有创口小、安全有效且并发症少等优点广泛被临床应用[1]。但术中需予患者麻醉处理，减轻患者疼痛，而临床中常用诱导剂七氟烷予患者喉罩全麻处置，因七氟烷具有苏醒迅速的特点，单独应用时用量较大，进而影响患者血流动力学[2-3]。右美托咪定作为α2肾上腺受体激动剂，具有明显的镇静、镇痛作用，广泛应用于复合麻醉[4]。近年来，复合麻醉凸显出其优势，本院采用右美托咪定静脉泵注联合七氟烷吸入麻醉在宫腔镜电切术中取得了较好的效果，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年1-12月于本院进行宫腔镜电切术的62例患者为研究对象。纳入标准：

（1）根据病史、临床表现、影像学检查，明确诊断为子宫疾病;（2）采用宫腔镜电切术者;（3）年龄18～58岁;（4）麻醉ASA分级为Ⅰ、Ⅱ级。排除标准：（1）合并严重器质性病变;（2）合并精神异常者。……