俞峰　孫衛(wèi)東　鄭永志

【摘要】 目的：探討右美托咪定在內(nèi)鏡黏膜下剝離術(shù)中的應(yīng)用價值。方法：129例擬行內(nèi)鏡黏膜下剝離術(shù)的患者，采用隨機數(shù)字表法平均分為三組，對照組（A組）采用單用丙泊酚麻醉，研究組（B組）采用右美托咪定[0.2 ?g/（kg·h）]復(fù)合丙泊酚麻醉，研究組（C組）采用右美托咪定[0.3 ?g/（kg·h）]

復(fù)合丙泊酚麻醉。術(shù)后評估麻醉效果，比較麻醉時間、手術(shù)時間及蘇醒時間，各組的丙泊酚用量，以及不良反應(yīng)發(fā)生情況等。結(jié)果：與A組比較，研究組的麻醉效果較優(yōu)（P<0.05），但B組、C組間比較差異無統(tǒng)計學(xué)意義（P>0.05）;各組患者麻醉時間、手術(shù)時間比較差異無統(tǒng)計學(xué)意義（P>0.05）;研究組C組的蘇醒時間明顯長于A組和B組（P<0.05），同時A組和B組的蘇醒時間相比差異無統(tǒng)計學(xué)意義（P>0.05）;與A組比較，研究組的丙泊酚用量顯著低于對照組（P<0.05），但B組、C組比較差異無統(tǒng)計學(xué)意義（P>0.05）;B組不良反應(yīng)發(fā)生率最低（P<0.05）。結(jié)論：在內(nèi)鏡黏膜下剝離術(shù)中采用右美托咪定[0.2 ?g/（kg·h）]復(fù)合丙泊酚的麻醉方式，可以為手術(shù)操作提供理想的麻醉效果，減少丙泊酚用量，減少不良反應(yīng)，是安全有效的麻醉方法。

【關(guān)鍵詞】 右美托咪定; 丙泊酚; 麻醉; 內(nèi)鏡黏膜下剝離術(shù)

doi：10.14033/j.cnki.cfmr.2019.05.011 文獻標(biāo)識碼 B 文章編號 1674-6805（2019）05-00-03

Application of Dexmedetomidine in Patients Undergoing Endoscopic Submucosal Dissection/YU Feng，SUN Weidong，ZHENG Yongzhi.//Chinese and Foreign Medical Research，2019，17（5）：-27

【Abstract】 Objective：To investigate the application of Dexmedetomidine in patients undergoing endoscopic submucosal dissection（ESD）.Method：129 patients in need of ESD in our hospital were selected.They were randomly divided into control group A（injected with only Propofol），study group B[injected with Propofol and low-dose Dexmedetomidine 0.2 ?g/（kg·h）] and study group C[injected with Propofol and low-dose Dexmedetomidine 0.3 ?g/（kg·h）].The analgesia effects，analgesia time，operative time，wake up time，the dose of propofol and adverse reactions were recorded in the 24 h after the treatment.Result：Compared with group A，the analgesia effects in group B and group C were better with statistically significant（P<0.05）.However there was no statistically significant differences between group B and group C（P>0.05）.Compared with group C，the wake up time in group A and group B were longer with statistically significant（P<0.05）.However there was no statistically significant differences between group A and group B（P>0.05）.There was no significant difference in analgesia time and operative time（P>0.05）.The wake up time of group C was significantly longer than that of group A and group B（P<0.05），and there was no significant difference between group A and group B（P>0.05）.Compared with group A，the dose of Propofol in group B，group C were lower with statistically significant（P<0.05）.However there was no statistically significant differences between group B and group C（P>0.05）.The adverse reactions in group B were significantly lower than that in group A and group C（P<0.05）.Conclusion：The application of Propofol and low-dose Dexmedetomidine[2 ?g/（kg·h）] is safe and effective in patients undergoing endoscopic submucosal dissection.It also can reduce the the dose of Propofol and improve the satisfaction of patients.