妊娠期高血压综合征患者剖宫产术中应用右美托咪定的临床效果

摘要

目的 分析妊娠期高血压综合征患者剖宫产术中应用右美托咪定的临床效果.方法 选取石家庄市第四医院自2014年5月至2016年5月收治的妊娠期高血压综合征患者80例,采取随机数字表法分为对照组与观察组,每组各40例,两组均给予腰硬联合麻醉后,断脐后2min,观察组给予右美托咪定0.5μg/kg静脉泵入,时间设定为10min,对照组给予同等剂量生理盐水,对比两组镇静评分、围术期血流动力学参数、并发症发生率.结果 观察组与对照组相比镇静评分为1分、3分及4分的患者明显多于对照组,说明观察组的镇静情况优于对照组,差异有统计学意义(χ2值分别为5.77、4.75、5.78,均P<0.05).观察组T1、T2、T3时间段MAP、HR与T0时间段相比降低,差异均有统计学意义(t=3.19~3.45,均P<0.05).观察组与对照组相比T1、T2、T3时间段MAP及HR较低,差异均具有统计学意义(t=3.34~4.34,均P<0.05).观察组与对照组相比血压异常、心动过缓及寒颤的发生率较低,差异具有统计学意义(χ2值分别为6.25、6.36、7.12,均P<0.05).结论 妊娠期高血压综合征患者剖宫产术中应用右美托咪定可发挥良好的镇静作用,确保围术期血流动力学的稳定,并发症发生率低,安全性高.%Objective To explore the clinical effect of applying dexmedetomidine in cesarean section in patients with gestational hypertension syndrome.Methods From May 2014 to May 2016 totally 80 cases of gestational hypertension syndrome were selected in Fourth Hospital in Shijiazhuang City, and they were divided into control group and observation group with random table method with 40 cases in each group.With combined spinal and epidural anesthesia and 2 minutes after umbilical cord was cut, the observation group was intravenously given dexmedetomidine 0.5μg/kg, pumping for 10 min, while the control group was given equal dose of normal saline.Two groups were compared in terms of sedation score, perioperative hemodynamic index and incidence of complications.Results Compared to the control group, the patients in the observation group with 1 point, 3 points and 4 points were more, which suggested better sedation effect in the group and the difference was statistically significant (χ2 value was 5.77, 4.75 and 5.78, respectively, all P<0.05).In the observation group, MAP and HR at T1, T2 and T3 were lower than at T0 with statistical significance (t value ranged 3.19 to 3.45, all P<0.05).MAP and HR at T1, T2 and T3 were significantly lower in the observation group than in the control group (t value ranged 3.34 to 4.34, all P<0.05).The incidence of abnormal blood pressure, bradycardia and chills was lower in the observation group (χ2 value was 6.25, 6.36 and 7.12, respectively, all P<0.05).Conclusion Applying dexmedetomidine in cesarean section in patients with gestational hypertension syndrome obtains good sedation effect and can ensure the stability of perioperative hemodynamics with low complications incidence and high safety.