2024 年第 9 期 第 0 卷

右美托咪定麻醉对肾功能不全血液透析患者血流动力学和满意度的影响

Effects of dexmedetomidine anesthesia on hemodynamics and satisfaction in hemodialysis patients with renal insufficiency

作者：常倩1侯国清2岳海龙2马俊涛2

英文作者：Chang Qian1 Hou Guoqing2 Yue Hailong2 Ma Juntao2

单位：1河北省唐山中心医院血液透析室，唐山063000；2河北省唐山中心医院麻醉科，唐山063000

英文单位：1Hemodialysis Room Tangshan Central Hospital Hebei Province Tangshan 063000 China; 2Department of Anesthesiology Tangshan Central Hospital Hebei Province Tangshan 063000 China

关键词：右美托咪定；血液透析；麻醉；血流动力学

英文关键词：Dexmedetomidine;Hemodialysis;Anesthesia;Hemodynamics

• 摘要：

• 目的 探讨右美托咪定麻醉对肾功能不全血液透析患者血流动力学和满意度的影响。方法 选取2020年11月至2023年11月河北省唐山中心医院收治的肾功能不全血液透析患者80例，按随机数字表法分为对照组和观察组，各40例。对照组实施常规治疗措施，观察组在对照组治疗的基础上静脉输注盐酸右美托咪定。比较2组麻醉用药前和用药后20、30 min血压、心率、脉搏血氧饱和度（SpO2）。比较2组肾功能指标β2微球蛋白（β2-MG）、血肌酐、血尿酸、血尿素氮、血磷水平。通过自制满意度调查表比较2组患者满意度情况。结果 麻醉用药后20、30 min，观察组患者收缩压、舒张压、心率均低于对照组，差异均有统计学意义（均P＜0.05），2组SpO2比较，差异均无统计学意义（均P＞0.05）。透析后观察组患者β2-MG、血肌酐、血尿酸、血尿素氮、血磷水平均低于对照组［（30±5）mg/L比（35±6）mg/L、（120±14）μmol/L比（181±21）μmol/L、（257±32）mmol/L比（295±34）mmol/L、（10±3）mmol/L比（18±5）mmol/L、（1.1±0.3）mmol/L比（1.4±0.4）mmol/L］，差异均有统计学意义（均P＜0.05）。观察组患者总满意率明显高于对照组［100.0%(40/40)比82.5%(33/40)］，差异有统计学意义（P＜0.05）。结论 右美托咪定应用于肾功能不全血液透析患者可稳定患者血流动力学指标，提高患者满意度，有较好的临床应用价值。

• Objective To investigate the effects of dexmedetomidine anesthesia on hemodynamics and satisfaction in hemodialysis patients with renal insufficiency. Methods A total of 80 hemodialysis patients with renal insufficiency admitted to Tangshan Central Hospital, Hebei Province from November 2020 to November 2023 were selected, and they were divided into control group and observation group according to the random number table method, with 40 cases in each group. The control group was given routine treatment, and the observation group was given intravenous infusion of dexmedetomidine hydrochloride on the basis of the treatment of the control group. Blood pressure, heart rate and pulse oximetry (SpO2) were compared between the two groups before and 20 min and 30 min after anesthesia. The renal function indicators β2-microglobulin (β2-MG), serum creatinine, serum uric acid, blood urea nitrogen, and blood phosphorus levels in both groups were compared. The self-designed satisfaction questionnaire was used to compare the satisfaction of patients in the two groups. Results The systolic blood pressure, diastolic blood pressure and heart rate of the observation group were lower than those of the control group 20 min and 30 min after anesthesia (all P＜0.05); there was no significant difference in SpO2 between the two groups (all P＞0.05). The levels of β2-MG, serum creatinine, serum uric acid, blood urea nitrogen, and blood phosphorus in the observation group were lower than those in the control group［(30±5)mg/L vs (35±6)mg/L, (120±14)μmol/L vs (181±21)μmol/L, (257±32)mmol/L vs (295±34)mmol/L, (10±3)mmol/L vs (18±5)mmol/L, (1.1±0.3)mmol/L vs (1.4±0.4)mmol/L］(all P＜0.05). The total satisfaction rate of patients in the observation group was significantly higher than that in the control group ［100.0%(40/40) vs 82.5%(33/40)］(P＜0.05). Conclusion The application of dexmedetomidine in hemodialysis patients with renal insufficiency can stabilize the hemodynamic indexes of patients and improve patient satisfaction, which has good clinical application value.