| 李军仕.右美托咪定复合氟比洛芬酯对重度烧伤切痂植皮患者全身麻醉苏醒期躁动､应激激素及血糖水平的影响[J].中国烧伤创疡杂志,2019,31(6):404~408. |
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| 中文关键词: 美托咪定 氟比洛芬酯 重度烧伤 植皮 苏醒期 躁动 应激激素 血糖 |
| 英文关键词:Dexmedetomidine Flurbiprofen axetil Severe burn Skin grafting Recovery period Agitation Stress hormone Blood sugar |
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| 中文摘要: |
| 【摘要】 目的 观察右美托咪定复合氟比洛芬酯对行切痂植皮术治疗的重度烧伤患者全身麻醉苏醒期躁动?应激激素及血糖水平的影响?方法 按照随机数表法将2016 年2 月至2019 年2 月河南省省立医院收治的60例重度烧伤患者随机分为观察组(30 例) 和对照组(30 例), 其中观察组患者于全身麻醉切痂植皮术结束前30 min静脉注射右美托咪定0.25 μg/kg + 氟比洛芬酯50 mg, 对照组患者于全身麻醉切痂植皮术结束前30 min 静脉注射右美托咪定0.25 μg/kg, 对比观察两组患者手术持续时间?唤醒时间?拔管时间?Ramsay 镇静评分?Riker镇静-躁动评分?应激激素和血糖水平以及不良反应发生情况?结果 观察组患者手术持续时间?唤醒时间及拔管时间与对照组无明显差异(t = 0.798?1.044?0.874, P = 0.428?0.301?0.386); 观察组患者唤醒后Ramsay 镇静评分高于对照组(t =6.138, P =0.000)?Riker 镇静-躁动评分低于对照组(t =6.038, P =0.000);拔管后15 min, 观察组患者血浆醛固酮?肾上腺素?皮质醇及血糖水平均低于对照组(t =2.278?3.443?2.608?3.481, P =0.026?0.001?0.012?0.001), 且两组患者血浆醛固酮?肾上腺素?皮质醇及血糖水平均显著高于麻醉前, 组内对比, P 均<0.05, 差异具有统计学意义; 观察组患者不良反应发生率为10.0%, 与对照组患者的不良反应发生率16.7%无明显差异(χ2 =2.162, P =0.539)?结论 右美托咪定复合氟比洛芬酯能够有效降低重度烧伤切痂植皮患者全身麻醉苏醒期的躁动程度, 抑制应激激素及血糖水平的升高? |
| 英文摘要: |
| 【Abstract】 Objective To observe the effects of dexmedetomidine combined with flurbiprofen axetil on the agitation, stress hormone and blood glucose level during the recovery period after general anesthesia in patients who have undergone escharectomy and skin grafting for severe burns. Methods Sixty patients with severe burns admitted to Henan Provincial Hospital from February 2016 to February 2019 were divided, according to the random number table, into an observation group (30 cases) and a control group (30 cases). The patients in the observation group were given the intravenous injection
of dexmedetomidine 0.25 μg/kg + flurbiprofen 50 mg 30 min before the end of escharectomy and skin grafting under general anesthesia while the patients in the control group were simply given the intravenous injection of dexmedetomidine 0.25 μg/kg 30 min before the end of escharectomy and skin grafting under general anesthesia. The operative time, awaking time, extubation time, Ramsay sedation score, Riker sedation-agitation score, stress hormone and blood glucose level, and the occurrence of adverse reactions were observed and compared between the two groups. Results No significant difference was observed in terms of operative time, awaking time and extubation time between the observation group and the control group(t =0.798, 1.044 and 0.874 respectively, P = 0.428, 0.301 and 0.386 respectively). The Ramsay sedation score was higher in the observation group than that in the control group (t = 6.138, P = 0.000), while the Riker sedation-agitation score in the observation group was lower than that in the control group (t = 6.038, P = 0.000). 15 min after the extubation, the levels of plasma aldosterone, adrenaline, cortisol and blood glucose in the observation group were all lower than that in the control group (t =2.278, 3.443, 2.608 and 3.481 respectively, P =0.026, 0.001, 0.012 and 0.001 respectively). Their levels were all significantly higher than that before the anesthesia and the within-group differences were statistically significant (P <0.05). No significant difference was observed in terms of the incidence of adverse reactions between the observation group and the control group (10.0% vs.16.7%, χ2 = 2.162, P = 0.539). Conclusion The combined application of Dexmedetomidine and flurbiprofen axetil can effectively relieve agitation and inhibit the increases of stress hormones and blood glucose level of severe burn patients during the recovery period after general anesthesia for escharectomy and skin grafting. |
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