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目的:探讨经皮肝脏肿瘤射频消融术(PRFA)中应用盐酸右美托咪啶(Dex)复合丙泊酚静脉麻醉的临床效果和安全性。方法:将60例择期行PRFA的患者随机分为Dex组(D组)和丙泊酚组(P组),每组30例。D组静脉泵注丙泊酚复合Dex,P组静脉泵注丙泊酚和生理盐水。记录两组患者入室后(T0)、诱导后(T1)、射频消融开始后5 min(T2)、10 min(T3)及手术结束后30 min(T4)的平均动脉压(MAP)、心率和血氧饱和度,记录两组患者的手术时间、清醒时间、丙泊酚用量,记录术中呼吸抑制、体动、低血压、术后恶心呕吐等并发症,记录术后镇痛评分(VAS评分)、Ramsay镇静评分。结果:D组在T1、T2、T3的血压高于P组,心率低于P组(P<0.05);D组术后清醒时间短于P组,丙泊酚用量少于P组,D组术中出现体动和低血压比例低于P组,术后D组VAS评分优于P组(P<0.05);术后恶心呕吐发生率和Ramsay镇静评分两组比较,差异无统计学意义(P>0.05)。结论:Dex复合丙泊酚可以减少患者术中丙泊酚用量,术中及术后不良反应少,是PRFA较为理想的麻醉方式。
Objective: To investigate the clinical efficacy and safety of intravenous dexmedetomidine propofol anesthesia in percutaneous transluminal radiofrequency ablation (PRFA). Methods: Sixty patients scheduled for PRFA were randomly divided into Dex group (D group) and propofol group (P group), 30 cases in each group. Group D was infused with Propofol Dex, and Group P was infused with propofol and saline. The mean arterial pressure (MAP) and heart rate (HR) were recorded after T0, T1, 5 min (T2), 10 min (T3) and 30 min (T4) after radiofrequency ablation Oxygen saturation was recorded. The operation time, awake time, propofol dosage, respiratory depression, body movement, hypotension and postoperative nausea and vomiting were recorded. The postoperative analgesia score (VAS score ), Ramsay sedation score. Results: The blood pressure of group D at T1, T2 and T3 was higher than that of group P, and the heart rate was lower than that of group P (P <0.05). The awake time of group D was shorter than group P and the dosage of propofol was less than group P There was no significant difference between the two groups in the incidence of nausea and vomiting and the Ramsay sedation score after operation (P <0.05) (P> 0.05). Conclusion: Dex combined with propofol can reduce the dosage of propofol in patients with intraoperative and postoperative adverse reactions, is an ideal way of anesthesia PRFA.