發(fā)布時(shí)間：2018-03-08 08:31

  本文選題：艾司洛爾　切入點(diǎn)：右美托咪定　出處：《上海交通大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：背景：控制低血壓是一種常用來(lái)減少術(shù)中失血,改善手術(shù)視野,減少手術(shù)時(shí)間,從而減少輸血的技術(shù)。對(duì)于身體健康的患者將MAP降低至50-60mmHg，通常是可以耐受的。 目的：這個(gè)雙盲、隨機(jī)、對(duì)照研究的目的是比較右美托咪定（一種短效的中樞性α2受體激動(dòng)劑）與艾司洛爾（一種短效的β受體阻滯劑）在正頜外科手術(shù)中，包括LefortI型截骨術(shù)、下頜升支截骨術(shù)等，進(jìn)行控制性降壓，控制術(shù)中出血的作用，，以幫助麻醉醫(yī)師及外科醫(yī)師在術(shù)前對(duì)術(shù)中輸血補(bǔ)液及手術(shù)等情況做好充分的準(zhǔn)備。 方法：將90名17-36歲，ASA分級(jí)I-II級(jí)的患者隨機(jī)分為右美組、艾司洛爾組及硝酸甘油組（對(duì)照），所有患者全部接受靜吸復(fù)合全身麻醉，術(shù)中進(jìn)行控制性降壓。記錄HR、MAP、控制性降壓時(shí)間、達(dá)到目標(biāo)血壓時(shí)間、術(shù)中失血量、瑞芬太尼的用量、術(shù)后蘇醒時(shí)間及術(shù)中術(shù)野質(zhì)量評(píng)定。 結(jié)果：3組術(shù)中出血量無(wú)顯著差異，瑞芬太尼的用量右美組明顯少于艾司洛爾組，而艾司洛爾組在恢復(fù)時(shí)間上比右美組相對(duì)較短。結(jié)論：右美托咪定與艾司洛爾均可提良好的控制性降壓效果，減少術(shù)中失血，而右美托咪定與艾司洛爾相比顯著延長(zhǎng)了術(shù)后蘇醒時(shí)間。
[Abstract]:Background: hypotension control is a technique commonly used to reduce intraoperative blood loss, improve operative visual field, and reduce operative time, thereby reducing blood transfusion. For healthy patients, lowering MAP to 50-60 mm Hg is generally tolerable. Objective: this double-blind, randomized, controlled study was designed to compare dexmetomidine (a short-acting central 偽 2-receptor agonist) with esmolol (a short-acting beta blocker) in orthognathic surgery. Including LefortI osteotomy, mandibular ramus osteotomy and so on, the effect of controlled hypotension and bleeding control was carried out to help anesthesiologists and surgeons prepare well for transfusion and resuscitation before operation. Methods: 90 patients aged 17-36 years with ASA grade I-II were randomly divided into right group, esmolol group and nitroglycerin group (control group, all patients received intravenous inhalation combined with general anesthesia). Control hypotension was performed during the operation, HRP MAP, controlled hypotension time, time to reach target blood pressure, blood loss during operation, dosage of remifentanil, postoperative recovery time and quality evaluation of operative field were recorded. Results there was no significant difference in the volume of intraoperative bleeding among the three groups, and the dosage of remifentanil in the right group was significantly lower than that in the esmolol group. The recovery time of esmolol group was shorter than that of right American group. Conclusion: both dexmetomidine and esmolol have good controlled hypotension effect and reduce intraoperative blood loss. Dexmetomidine significantly prolonged postoperative recovery time compared with esmolol.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 周其富;蔣宗明;鄭羨河;范洪輝;;右美托咪定復(fù)合硝普鈉控制性降壓對(duì)脊柱手術(shù)患者腎素-血管緊張素-醛固酮系統(tǒng)的影響[J];醫(yī)學(xué)研究雜志;2012年11期

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