论文部分内容阅读
目的:探讨右美托咪啶联合丙泊酚麻醉对高血压脑出血手术患者血液流变学及血流动力学的影响。方法:选取2017年6月至2019年6月滕州市中心人民医院126例高血压脑出血急诊手术患者为研究对象，进行前瞻性设计，随机数字表法分为对照组(63例)、观察组(63例)。对照组予丙泊酚进行诱导麻醉，观察组予右美托咪啶联合丙泊酚诱导麻醉。比较两组手术过程中血流动力学、术前术后血液流变学、临床疗效及术后并发症。结果:两组术后24 h全血黏度中切、血浆黏度水平均高于同组术前，红细胞聚集指数低于同组术前，组内差异有统计学意义(n P<0.05)；术后24 h观察组全血黏度中切、血浆黏度水平、红细胞变形指数低于同期对照组，红细胞聚集指数高于同期对照组，组间差异有统计学意义(n P<0.01)。观察组HR、SP在Tn 1、Tn 2、Tn 3时水平处于正常范围且低于同期对照组，组间差异有统计学意义(n P0.05)；观察组清醒时间快于对照组，组间差异有统计学意义(n P<0.01)。对照组术后烦躁、咽痛、恶心呕吐、再出血总并发症发生率25.4%，观察组总并发症发生率9.5%，组间差异有统计学意义(n P0.05); 24 hours after operation, the whole blood viscosity, plasma viscosity levels and the erythrocyte deformation index of the observation group were lower than those of the control group, and the erythrocyte aggregation index was higher than those of the control group, with statistically significant difference (n P<0.01). The levels of heart rate (HR) and systolic pressure (SP) in the observation group at Tn 1, Tn 2 and Tn 3 were normal and lower than those in the control group at the same time (n P0.05); the awakening time of the observation group was faster than that of the control group (n P<0.01). The incidence of restlessness, pharyngalgia, nausea, vomiting and rebleeding in the control group was 25.4%, higher than that in the observation group (9.5%), with statistically significant difference (n P<0.05).n Conclusions:Dexmedetomidine combined with propofol induced anesthesia can stabilize intraoperative hemodynamics, improve postoperative hemorheology, promote postoperative awakening and reduce postoperative complications in patients with hypertensive intracerebral hemorrhage.