摘要
目的:观察椎体压缩骨折患者经皮椎体成形术(PVP)中瑞芬太尼联合右美托咪定的麻醉效果以及对凝血功能的影响。方法:选择本院2019年1月—2020年6月收治的椎体压缩骨折患者70例作为研究对象,所有患者均行PVP治疗,根据麻醉方法将其分为2组,每组35例,对照组采用瑞芬太尼药物麻醉,观察组在对照组基础上联用右美托咪定,比较2组患者心率水平、血压指标、麻醉效果、凝血功能指标及不良反应情况。结果:(1)T_(0)时刻,2组患者心率、血压水平相近,组间差异无统计学意义(P>0.05)。T_(1)、T_(2)、T_(3)、T_(4)时刻,2组患者的心率、血压水平均显著低于T_(0)时刻,组内差异有统计学意义(P<0.05),且观察组降低幅度高于对照组,组间差异有统计学意义(P<0.05)。(2)相对于对照组,观察组苏醒时间、拔管时间更短,镇静评分更高,组间差异有统计学意义(P<0.05)。(3)术前,2组患者凝血功能指标对比无较大差异,组间差异无统计学意义(P>0.05);术后,观察组患者PT、APTT长于对照组,FIB、PLT指标低于对照组,组间差异有统计学意义(P<0.05)。(4)2组患者不良反应对比,组间差异无统计学意义(P>0.05)。结论:瑞芬太尼联合右美托咪定在经皮椎体成形术中麻醉效果稳定,对凝血功能影响较小,且麻醉安全度高,优势明显,临床可广泛应用。
Objective:Observe the anesthetic effect of remifentanil combined with dexmedetomidine during percutaneous vertebroplasty in patients with vertebral compression fracture and its influence on blood coagulation function.Methods:70 patients with vertebral compression fracture admitted to our hospital from January 2019 to June 2020 were selected as the study subjects.All patients were treated with PVP.They were divided into two groups according to the anesthesia method,with 35 patients in each group.The control group was anesthetized with remifentanil,The observation group was combined with dexmedetomidine on the basis of the control group,The heart rate,blood pressure,anesthetic effect,coagulation function and adverse reactions were compared between the two groups.Results:(1)At T_(O),the heart rate and blood pressure of the two groups were similar,and there was no significant difference between the two groups(P>0.05).The heart rate and blood pressure levels of patients in the two groups at T_(1),T_(2),T_(3) and T_(4) were significantly lower than those at TO,and the intra-group dfferences were statistically significant(P<0.05).The decrease of the observation group was significantly higher than that of the control group(P<0.05);(2)Compared with the control group,the observation group had shorter awakening time,shorter extubation time and higher sedation score,and the difference between the two groups was statistically significant(P<0.05);(3)Before operation,there was no significant difference in coagulation function between the two groups(P>0.05);After operation,the PT and APTT of patients in the observation group were longer than those in the control group,and the FIB and PLT indexes were lower than those in the control group.The difference between the two groups was statistically significant(P<0.05);(4)There was no significant difference in adverse events between the two groups(P>0.05).Conclusion:Remifentanil combined with dexmedetomidine has a stable anesthetic effect in percutaneous vertebroplasty,has a small impact on coagulation function,and has a high anesthetic safety and obvious advantages,which can be widely used.
作者
庄莉辉
ZHUANG Lihui(Department of anesthesiology,central hospital of Dashiqiao city,Dashiqiao,Liaoning 115000)
出处
《中国伤残医学》
2023年第23期20-23,共4页
Chinese Journal of Trauma and Disability Medicine
关键词
椎体压缩骨折
经皮椎体成形术
瑞芬太尼
右美托咪定
凝血功能
Vertebral compression fracture
Percutaneous vertebroplasty
Remifentanil
Dextrmetomidine
Coagulation function
