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-  2015 

右美托嘧啶单独应用在经气管镜介入治疗中的应用价值探讨

DOI: doi:10.7507/1671-6205.2015051

Keywords: 咪达唑仑, 枸橼酸芬太尼, 右美托嘧啶, 气管镜

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Abstract:

目的探讨右美托嘧啶单独应用在经气管镜介入治疗中的效果及其对患者呼吸、循环、并发症的影响。 方法选取2012年4月至2014年5月在本科室拟行气管镜介入治疗的成年患者60例,采用随机数字表法,将患者分为两组:咪达唑仑联合枸橼酸芬太尼静脉注射组(MF组)和右美托嘧啶靶控输注组(Y组),每组30例,术前均先予2%利多卡因15 mL超声雾化吸入行局部表面浸润麻醉。然后分别予MF组咪达唑仑枸橼酸芬太尼缓慢静脉注射,Y组行右美托嘧啶0.5 μg静脉注射后再按0.2 μg/h维持。记基础值(T0)、气管镜进入咽腔时(T1)、进入声门时(T2)、进入支气管时(T3)的时间点并进行镇静评分。对比分析两种治疗效果。 结果两组患者术中躁动、低血压、高血压、心动过速发生率的差异均无统计学意义(P值均>0.05)。两组基础Ramsay评分组间比较差异无统计学意义(P>0.05);组间比较显示T0、T1时Ramsay评分差异无统计学意义(P>0.05),而T2、T3时Ramsay评分差异有统计学意义(P<0.05)。Y组患者术中出现呼吸抑制、低氧血症的发生率显著低于MF组(P值均<0.05),而MF组苏醒时间显著长于Y组(P<0.05)。Y组患者经简单呼叫后即可苏醒,而MF组23例患者需静脉注射氟马西尼促醒。 结论右美托嘧啶可为经气管镜介入治疗提供有效镇静,且效果良好、安全性高、唤醒更简便

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