[1]吴 勇、黄书岚、观龙彬、容嘉彬.右美托咪定联合地佐辛在自发性脑出血开颅术后镇静、镇痛中的疗效观察[J].中国临床神经外科杂志,2019,(08):480-482.[doi:10.13798/j.issn.1009-153X.2019.08.010]
 WU Yong,HUANG Shu-lan,GUAN Long-bin,et al.Effect of dezocine combined with dexmedetomidine on the analgesia and sedation after craniotomy in patients with spontaneous intracerebral hemorrhage[J].,2019,(08):480-482.[doi:10.13798/j.issn.1009-153X.2019.08.010]
点击复制

右美托咪定联合地佐辛在自发性脑出血开颅术后镇静、镇痛中的疗效观察()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年08期
页码:
480-482
栏目:
论著
出版日期:
2019-08-25

文章信息/Info

Title:
Effect of dezocine combined with dexmedetomidine on the analgesia and sedation after craniotomy in patients with spontaneous intracerebral hemorrhage
文章编号:
1009-153X(2019)08-0480-03
作者:
吴 勇、黄书岚、观龙彬、容嘉彬
430060 武汉,武汉大学人民医院神经外科(吴 勇、黄书岚、观龙彬、容嘉彬)
Author(s):
WU Yong HUANG Shu-lan GUAN Long-bin RONG Jia-bin.
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
关键词:
自发性脑出血开颅血肿清除术右美托咪定地佐辛镇静镇痛
Keywords:
Spontaneous intracerebral hemorrhage Dexmedetomidine Dezocine Analgesia Sedation
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2019.08.010
文献标志码:
A
摘要:
目的 探讨右美托咪定联合地佐辛对自发性脑出血开颅术后镇静、镇痛的临床疗效。方法 回顾性分析2017年9月至2018年9月开颅血肿清除术治疗的符合标准的56例SICH的临床资料。根据术后镇静、镇痛方式分成观察组(28例)和对照组(28例)。观察组采用右美托咪定联合地佐辛治疗,对照组采用咪达唑仑联合地佐辛治疗。结果 用药后2、6、12、24 h,观察组镇静Ramsay评分、镇痛视觉模拟量表(VAS)评分、恶心呕吐AVS评分、平均动脉压、心率较对照组均明显降低(P<0.05),而SpO2均明显提高(P<0.05)。观察组住院时间[(19.86±3.76)d]较对照组[(23.61±5.78)d]明显缩短(P<0.05)。观察组再出血率(3.57%,1/28)与对照组(10.71%,3/28)无统计学差异(P>0.05)。结论 右美托咪定联合地佐辛对自发性脑出血开颅术后病人具有良好的镇静、镇痛作用,能够稳定术后血流动力学指标,减少住院时间。
Abstract:
Objective To explore the effect of dezocine combined with dexmedetomidine on the analgesia and sedation after craniotomy in the patients with spontaneous intracerebral hemorrhage (SICH). Methods Of 56 patients with SICH who underwent craniotomy for evacuation of hematomas in our hospital from September, 2017 to September, 2018, 28 (observation group) were treated with dexmedetomidine and dezocine, and 28 (control group) were treated with dezocine and midazolam. The Ramsay sedation score, the score of analgesia visual analogue scale (VAS) and nausea and vomiting VAS, mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SPO2), rebleeding rate and the length of hospital stays were compared between both the groups. Results The Ramsay sedation scores and SPO2 were significantly higher in the observation group than that in the control group 2, 6, 12 and 24 hours after the treatment (P<0.05). The scores of analgesia VAS and nausea and vomiting VAS, MAP and HR were significantly lower than those in the control group 2, 6, 12 and 24 hours after the treatment (P<0.05). MAP and HR were significantly lower in the observation group in the observation group after the treatment than those before the treatment in the observation group (P<0.05). SpO2 was significantly higher after the treatment than that before the treatment in the observation group (P<0.05). There was insignificantly difference in the rebleeding rate between both the groups (P>0.05). The hospital stays was significantly shorter in the observation group than that in the control group (P<0.05). Conclusions Dexmedetomidine combined with dezocine has significantly effect on analgesia and sedation and can stabilize postoperative hemodynamic parameters and reduce hospital stays in the patients with SICH undergoing craniotomy.

参考文献/References:

[1] 王 龙,陈谦学,刘骏辉,等. 颅内压监测辅助下钻孔引流 术治疗自发性脑出血的临床疗效分析何晓云[J]. 中国临 床神经外科杂志,2018,23(9):581-584. [2] 马 俊,周 勇,马元施,等. 经外侧裂-岛叶入路显微手 术治疗高血压性基底节区出血的疗效分析[J]. 中国临床 神经外科杂志,2018,23(9):613-615. [3] 徐 兵,雍成明,杨代明. 高血压性脑出血手术预后的影 响因素分析[J]. 中国临床神经外科杂志,2018,23(10): 662-664. [4] Chif L, Lang TC, Sun SJ, et al. Relationship between diffe- rent surgical methods, hemorrhage position, hemorrhage volume, surgical timing, and treatment outcome of hyper- tensive intracerebral hemorrhage [J]. World J Emerg Med, 2014, 5(3): 203-208. [5] 张冰峰. 右美托咪啶复合盐酸瑞芬太尼对高血压脑出血 病人术后镇静镇痛中的应用研究[J]. 临床医药文献电子 杂志,2016,3(49):9844-9846. [6] 吕晨芳,王瑞杰,李 伟. 高血压脑出血病人开颅血肿清 除术后镇静治疗效果及其预后影响因素研究[J]. 实用心 脑肺血管病杂志,2018,26(4):32-36. [7] 姜淑云,徐红阳,王大鹏,等. 地佐辛联合右美托咪定在肺 移植手术后病人镇痛镇静效应的效果观察[J]. 广东医 学,2018,39(1):53-55. [8] 李萌盟. 右美托咪定联合芬太尼对高血压脑出血病人术 后认知功能的影响[J]. 内科急危重症杂志,2018,24(4): 301-305. [9] Yao ZY, Jia Z, Xie YH, et al. Analgesic effect of dezocine in different doses on elderly patients undergoing abdominal operation under general anesthesia and its influence on stress response to postoperative tracheal extubation [J]. Eur Rev Med Pharmacol Sci, 2017, 21(22): 5223-5229. [10] 王本琳,王慧星,周海旭,等. 右美托咪定联合布托啡诺对 高血压性脑出血病人镇痛、镇静的疗效观察[J]. 中国临 床神经外科杂志,2018,23(12):792-794. [11] 张 鹏,武红会,等. 田环环自发性脑出血术中不同平均 动脉压水平对术后心肌损伤的影响[J]. 临床麻醉学杂 志,2019,35(1):78-80. [12] 郝丹丹,穆 峰,王保国,等. 地佐辛单次静脉注射对病人 痛阈、自主呼吸及意识的影响[J]. 中国医药导报,2019, 16(1):114-118. [13] Zhao J, Zhou C. The protective and hemodynamic effects of dexmedetomidine on hypertensive cerebral hemorrhage patients in the perioperative period [J]. Exp Ther Med, 2016, 12(5): 2903-2908.

相似文献/References:

[1]霍龙伟.钻孔引流术与开颅清除术治疗高血压脑出血114例[J].中国临床神经外科杂志,2015,(06):372.[doi:10.13798/j.issn.1009-153X.2015.06.020]
[2]田 军 屈 浙 姜 博 宋春旺 左书浩.钻孔引流术联合开颅血肿清除术治疗急危重症高血压性脑出血[J].中国临床神经外科杂志,2017,(05):305.[doi:10.13798/j.issn.1009-153X.2017.05.007]
 TIAN Jun,QU Zhe,JIANG Bo,et al.Treatment of acute severe hypertensive cerebral hemorrhage by burr hole drainage combined with craniotomy evacuation of hematomas[J].,2017,(08):305.[doi:10.13798/j.issn.1009-153X.2017.05.007]
[3]朱郭婷 陈思思 黄书岚.血清淀粉样蛋白A与自发性脑出血预后的关系[J].中国临床神经外科杂志,2017,(08):539.[doi:10.13798/j.issn.1009-153X.2017.08.005]
 ZHU Guo-ting,CHEN Si-si,HUANG Shu-lan..Relationship of serum level of amyloid protein A with prognoses in patients with acute spontaneous intracerebral hemorrhage[J].,2017,(08):539.[doi:10.13798/j.issn.1009-153X.2017.08.005]
[4]廖建明 综述 陈谦学 审校.自发性脑出血急性期药物治疗研究进展[J].中国临床神经外科杂志,2017,(12):857.[doi:10.13798/j.issn.1009-153X.2017.12.021]
[5]林清国 杨 修 杨武双 刘东辉 王文阳 孟 涵 郑家地 黄惠勇.亚低温治疗自发性脑出血的临床疗效和安全性[J].中国临床神经外科杂志,2018,(04):240.[doi:10.13798/j.issn.1009-153X.2018.04.006]
 LIN Qing-guo,YANG Xiu,YANG Wu-shuang,et al.Curative effects of mild hypothermia on spontaneous intracerebral hemorrhage and its safety[J].,2018,(08):240.[doi:10.13798/j.issn.1009-153X.2018.04.006]
[6]刘 伟 李德龙 戢太红.穿刺术联合开颅手术治疗外伤性脑疝28例[J].中国临床神经外科杂志,2018,(04):302.[doi:10.13798/j.issn.1009-153X.2018.04.028]
[7]王 鹏 刘丽娜 王志明 蔡 明.以脑出血为首发症状的绒毛膜癌脑转移1例[J].中国临床神经外科杂志,2018,(06):447.[doi:10.13798/j.issn.1009-153X.2018.06.024]
[8]王 龙,陈谦学,刘骏辉,等.颅内压监测辅助下钻孔引流术治疗自发性脑出血的临床疗效分析[J].中国临床神经外科杂志,2018,(09):581.[doi:10.13798/j.issn.1009-153X.2018.09.002]
 WANG Long,CHEN Qian-xue,LIU Jun-hui,et al.Clinical effects of drainage of hematoma cavity under intracranial pressure monitoring on spontaneous intracerebral hemorrhage[J].,2018,(08):581.[doi:10.13798/j.issn.1009-153X.2018.09.002]
[9]侯全运.机化型慢性硬膜下血肿1例[J].中国临床神经外科杂志,2019,(08):511.[doi:10.13798/j.issn.1009-153X.2019.08.022]
[10]谢明德 金 法 冯荣亮.高血压性脑出血血肿清除术后癫痫发作的影响因素分析[J].中国临床神经外科杂志,2019,(10):605.[doi:10.13798/j.issn.1009-153X.2019.10.009]
 XIE Ming-de,JIN Fa,FENG Rong-liang..Factors related to epileptic seizures after evacuation of intracerebral hematomas in patients with hypertensive intracerebral hemorrhage[J].,2019,(08):605.[doi:10.13798/j.issn.1009-153X.2019.10.009]

备注/Memo

备注/Memo:
通讯作者:黄书岚,E-mail:dongfuyufu@qq.com(2019-03-06收稿,2019-04-09修回)
更新日期/Last Update: 2019-08-25