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[摘要]
目的 观察右美托咪定联合静脉麻醉药抑制止血带引起的高血压的临床疗效和安全性。方法 选择术中需止血带行下肢骨科手术患者50名,随机分为对照组(25例)和治疗组(25例),对照组用丙泊酚复合瑞芬太尼维持麻醉,治疗组用右美托咪定、丙泊酚复合瑞芬太尼维持麻醉。比较两组术中止血带相关性高血压出现时间及发生率、术中患者生命体征和术后不良反应。结果 对照组止血带相关性高血压出现时间早于治疗组,止血带相关性高血压发生率高于治疗组(P<0.05)。治疗组术中血流动力学变化较对照组平稳。对照组术后不良反应发生率高于治疗组(P<0.05)。结论 右美托咪定联合静脉麻醉药可以在一定程度上抑制止血带引起的血压升高并降低止血带相关性高血压发生率,减少术后不良反应的发生。
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[Abstract]
Objective To observe the clinical effect and safety of dexmedetomidine combined with intravenous anesthetics in suppressing tourniquet-induced hypertension. Methods Patients (50 cases) who were undergoing orthopaedic surgeries of the lower extremities on tourniquet inflation were randomly divided into the treatment (25 cases) and control (25 cases) groups. In the control group, the patients were induced with propofol compound fentanyl to maintain anesthesia; while the patients in the treatment group were induced with dexmedetomidine, propofol compound fentanyl to maintain anesthesia. The rates of tourniquet-induced hypertension, the time point of developing to tourniquet-induced hypertension, the vital signs and adverse effects after surgery were compared between the two groups. Results The time point that patients developed to tourniquet-induced hypertension was earlier in the control group than that in the treatment group (P < 0.05), the rate that patients developed to tourniquet-induced hypertension was higher in the control group than that in the treatment group (P < 0.05). Intraoperative hemodynamic of the treatment group changed more smoothly than that in the control group. The incidence of postoperative adverse reaction in the control was higher than that in the treatment group (P < 0.05). Conclusion Dexmedetomidine combined with intravenous anesthetics could suppress the tourniquet to a certain extent caused by increased blood pressure, and could reduce the incidence of high blood pressure with tourniquet correlation, which could reduce the occurrence of postoperative adverse reactions.
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