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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2018年08期

页码:

121-123

栏目:

出版日期:

2018-09-10

文章信息/Info

Title:

Effect of Dexmetidine Combined with Nitroglycerin on Controlled Hypotension in Orthognathic Surgery

文章编号:

1008-6455（2018）08-0121-03

作者:

刘 玉¹; 刘存明²; 唐 安¹; 章梦娜¹

Author(s):

LIU Yu1; LIU Cun-ming2; TANG An1; ZHANG Meng-na1

关键词:

[关键词]右美托咪定; 硝酸甘油; 正颌手术; 控制性降压

Keywords:

Key words: dexmetidine;  nitroglycerin;  orthognathic surgery;  controlled hypotension

分类号:

R782.05

文献标志码:

A

摘要:

[摘要]目的：观察右美托咪定联合硝酸甘油用于正颌手术控制性降压的效果、安全性和不良反应。方法：选择拟择期行正
颌手术的患者60例，于术中行控制性降压。将所有患者随机分为观察组和对照组。观察组：30例，给予右美托咪定联合
硝酸甘油麻醉，气管插管后泵注右美托咪定；对照组：30例，给予生理盐水联合硝酸甘油，气管插管后泵注等量的生理盐
水。两组均在上颌骨准备截骨前10min开始泵注硝酸甘油，根据平均动脉压调整泵注速度，使目标MAP较诱导前降低30%，但
不低于60mmHg。在主要手术步骤结束，开始缝合时停用硝酸甘油。观察记录患者不同时间节点的有创平均动脉压（MAP）、
心率(HR)，记录患者达目标血压的时间、停药后血压恢复时间、术中出血量、硝酸甘油量以及术后患者拔管时间，观察术
后有无寒战、躁动、咽喉疼痛等并发症。结果：两组T2～T5时刻MAP与T1比较，差异有统计学意义（P ＜0.05）；两组组间
T2～T5时刻MAP相比，差异无统计学意义（P ＞0.05）；观察组T2～T5时刻HR与对照组同时刻相比明显降低，差异有统计学
意义（P ＜0.05）。两组患者开始实施降压达到目标血压的时间及硝酸甘油用量比较，差异有统计学意义（P ＜0.05）；两
组患者停药后恢复时间、术中出血量、术后拔管时间比较，差异无统计学意义（P ＞0.05）；观察组术后并发症发生率明显
低于对照组，差异有统计学意义（P ＜0.05）。结论：右美托咪定联合硝酸甘油用于正颌手术控制性降压的效果满意、安全
性高，术后不良反应发生率低。

Abstract:

Abstract: Objective To observe the effect, safety and adverse reactions of dexmedetomidine combined with nitroglycerin
in controlled hypotension during orthognathic surgery. Methods A total of 60 patients undergoing orthognathic surgery
were selected for controlled hypotension. All patients were randomly divided into two groups, with an average of 30 cases
in each group.The observation group was given dexmetidine combined with nitroglycerin,and the control group was given
normal saline combined with nitroglycerin.Observation group were pump injected dexmedetomidine after tracheal intubation
butthe control group received the same amount of saline.Both groups were all pump injected nitroglycerin 10 minutes
before cutting the upper jaw, according to the mean arterial pressure adjusting pump injection speed,to make the target MAP
induced by 30%，but not less than 60 mmHg. At the end of the main operation steps started stitching stop nitroglycerin
pump injection. The invasive mean arterial pressure (MAP) and heart rate (HR) of patients at different nodes were recorded.
The time of reaching the target blood pressure, recovery time of blood pressure after drug withdrawal, intraoperative blood
loss, nitroglycerin, and postoperative time of tube removal were recorded. Postoperative complications including chills,
restlessness and sore throat were observed. Results The difference of MAP and T1 between the two groups at T2-T5 time
is statistically significant（P ＜0.05）.There was no significant difference in MAP comparison at T2-T5 time between the
two groups（P ＞0.05）. The HR of T2-T5 in the observation group was significantly lower than that in the control group at
the same time （P ＜0.05）. There were significant differences between the two groups in the time of lowering blood pressure
and the dosage of nitroglycerin（P ＜0.05）, the time of recovery, the amount of blood loss during operation and the time of
extubation after extubation were compared between the two groups（P ＜0.05）. The incidence of postoperative complications
in the observation group was significantly lower than that in the control group（P ＜0.05）. Conclusion The effect of
dexmetidine combined with nitroglycerin on controlled hypotension in orthognathic surgery is satisfactory, high safety and low
incidence of postoperative adverse reactions.

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更新日期/Last Update: 2018-10-12