达克罗宁胶浆在行腹腔镜下胆囊切除术伴老年高血压患者全身麻醉中的效果观察
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摘要
目的观察达克罗宁胶浆在腔镜下胆囊切除手术伴老年高血压患者全身麻醉的影响。方法选择2015年3月～12月择期在我院气管插管全麻下行腹腔镜下胆囊切除手术的老年高血压患者60例,将入选患者根据随机数字表法分为A组和B组各30例。所有患者采用气管插管静吸复合麻醉,A组用达克罗宁胶浆均匀涂抹于气管导管的前端,B组常规应用等量石蜡油润滑气管导管。比较两组患者麻醉诱导前(T0)、气管插管即刻(T1)、气管插管后5min(T2)、拔除气管导管即刻(T3)、拔除气管导管后5min(T4)各时间点生命体征,镇静躁动评分,拔除气管导管期间出现呛咳、声嘶、咽喉部不适等不良反应的发生情况。结果 A组在T3、T4时间点的SBP、DBP均低于B组同时间点(P<0.05),HR均慢于B组同时间点(P<0.05),A组患者拔除气管导管期间的镇静躁动评分低于B组(P<0.05),A组拔管呛咳和咽部不适发生率均低于B组(P<0.05)。结论达克罗宁胶浆可以减轻老年高血压患者拔管期间的心血管应激反应,减少拔管期间不良反应,提高患者在围手术期的安全性和舒适性。
Objective To observe the influence of Dyclonine mucilage on Elderly patients with Hypertension in General Anesthesia.Methods 60 patients(ASAⅠ-Ⅱ)undergoing laparoscopic cholecystectomy in General Anesthesia were randomly divided into Dyclonine Mucilage group(A group) and control group(group B),30 cases in each group.The Dyclonine Mucilage and paraffin oil were applied to the catheter before general anaesthesia intubation, All patients were treated with tracheal intubation and inhalation anesthesia. Comparison of vital signsbefore at induction of anesthesia(T0) and endotracheal intubation(T1), 5 min after intubation(T2), and extubation immediately(T3), 5 min after extubation(T4), and Sedation Agitation Score(SAS), cough.hoarseness, throat discomfort adverse reactions occurred during tracheal extubation of two groups of patients.Results SBP,DBP,HR were lower in group A than those in group B at T3, T4 points during tracheal extubation(P<0.05),and SAS of group A were lower than that of group B during extubation sedation(P<0.05).Cough,throat discomfort incidence of patients after operation were lower in group A than those in group B(P<0.05).Conclusion Dyclonine mucilage could reduced the cardiovascular stress reaction during extubation in elderly patients with hypertension, reduced adverse reactions during extubation, and improve the safety and comfort of patients during perioperative period.
Objective To observe the influence of Dyclonine mucilage on Elderly patients with Hypertension in General Anesthesia.Methods 60 patients(ASAⅠ-Ⅱ)undergoing laparoscopic cholecystectomy in General Anesthesia were randomly divided into Dyclonine Mucilage group(A group) and control group(group B),30 cases in each group.The Dyclonine Mucilage and paraffin oil were applied to the catheter before general anaesthesia intubation, All patients were treated with tracheal intubation and inhalation anesthesia. Comparison of vital signsbefore at induction of anesthesia(T0) and endotracheal intubation(T1), 5 min after intubation(T2), and extubation immediately(T3), 5 min after extubation(T4), and Sedation Agitation Score(SAS), cough.hoarseness, throat discomfort adverse reactions occurred during tracheal extubation of two groups of patients.Results SBP,DBP,HR were lower in group A than those in group B at T3, T4 points during tracheal extubation(P<0.05),and SAS of group A were lower than that of group B during extubation sedation(P<0.05).Cough,throat discomfort incidence of patients after operation were lower in group A than those in group B(P<0.05).Conclusion Dyclonine mucilage could reduced the cardiovascular stress reaction during extubation in elderly patients with hypertension, reduced adverse reactions during extubation, and improve the safety and comfort of patients during perioperative period.
引文
[1]李飞,罗宗荣.盐酸达克罗宁胶浆对腹腔镜胆囊切除手术患者拔管应激的影响[J].中国冶金工业医学杂志,2015,32(2):229-230.
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[7]周新,府伟.临床生物化学与检验[M].北京:人民卫生出版社,2008:121-126.
[8]蔡红刚,许铁翼.达克罗宁胶浆在预防全麻气管插管咽喉部并发症中的效果[J].实用临床医药杂志,2014,18(11):134-136.
[2]王绍红,黄鑫,李江林,等.原发性高血压患者动脉弹性功能与血压分级、脉压的关系[J].贵阳中医学院学报,2014,36(5):87-89.
[3]Riker RR,Picard JT,Fraser GL.Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients[J].Crit Care Med,1999,27(7):1325-1329.
[4]庄心良,曾因明,陈伯銮.现代麻醉学[M].北京:人民卫生出版社,2003:1433-1435.
[5]吴新民.麻醉学高级教程[M].北京:人民军医出版社,2010:17.
[6]蔡瑛,刘亚娟,吴海莺,等.盐酸达克罗宁胶浆对声带息肉摘除术患者全麻苏醒期的影响[J].昆明医科大学学报,2015,36(7):81-83.
[7]周新,府伟.临床生物化学与检验[M].北京:人民卫生出版社,2008:121-126.
[8]蔡红刚,许铁翼.达克罗宁胶浆在预防全麻气管插管咽喉部并发症中的效果[J].实用临床医药杂志,2014,18(11):134-136.