Objective: To evaluate the efficacy and safety of dexmedetomidine as a basic analgesic sedative for patients with radiofrequency ablation of liver tumors. Methods: A total of 443 liver cancer patients underwent percutaneous radiofrequency ablation in the 302 Hospital of PLA from January 2015 to December 2016 were retrospectively studied. The experimental group was dexmedetomidine group, with a total of 165 cases. The control group was pethidine group with a total of 278 cases. The indexes of systolic blood pressure, diastolic blood pressure, heart rate and respiratory rate of two groups were collected before and after operation, and the VAS score and incidence of nausea and adverse reactions were recorded. Results: The results of the experimental group added dose of pethidine (64.6 mg) lower than that of the control group pethidine dose (90.8 mg), the difference was statistically significant (Z=-10.205 3, P<0.01). The experimental group and the control group with VAS score average value was not statistically significant(Z=1.801 9, P=0.076), group two with 4 points for the critical point of the stratification, more than 4 points and<4 group comparison, the test group VAS score greater than 4 were significantly lower than the control group (χ(2)=7.05, P=0.007 9). The systolic blood pressure and diastolic blood pressure in the experimental group were significantly lower than those before operation (P<0.01), while the systolic blood pressure and diastolic blood pressure in the control group significantly increased compared with those before operation. Dexmedetomidine has the effect of stabilizing hemodynamics. The heart rate of the two groups decreased, and the rate of heart rate decreased in the experimental group. In addition, dexmedetomidine did not significantly increase the incidence of nausea and vomiting compared with the control group. Conclusions: Dexmedetomidine is safe and effective as a basic drug for analgesic and sedative in patients with liver tumor radiofrequency ablation.
目的： 评价右美托咪定对行肝肿瘤射频消融术患者基础镇痛镇静效果的有效性和安全性。 方法： 回顾性收集2015年1月至2016年12月解放军第三○二医院接受经皮射频消融介入治疗的肝肿瘤患者443例，试验组为右美托咪定组，共165例，平均年龄56岁，其中男127例（77.0%），女38例（23.0%）；对照组为哌替啶组，共278例，平均年龄58岁，其中男223例（80.2%），女55例（19.8%）。收集两组患者术前、术中、术后的收缩压、舒张压、心率、血氧饱和度和呼吸频率等指标及患者VAS评分、恶心不良反应发生率记录。 结果： 试验组与对照组性别、年龄、体质量、术前收缩压、术前舒张压、术前心率及术前血氧饱和度差异均无统计学意义。试验组追加哌替啶剂量低于对照组哌替啶剂量（64.6比90.8 mg），差异有统计学意义（Z=-10.205 3，P<0.01）。试验组和对照组的术中VAS评分总平均值差异无统计学意义（Z=1.801 9，P=0.076），两组以4分为临界点进行分层时，≥4分和<4分组比较分析，试验组VAS评分≥4的患者数显著低于对照组（χ(2)=7.05，P=0.007 9）。试验组的术中收缩压及舒张压低于术前，差异有统计学意义（P<0.01），而对照组的术中收缩压及舒张压与术前比较，均显著升高。两组心率和血氧饱和度均有下降，其中试验组心率和血氧饱和度下降幅度更大。此外，右美托咪定与对照组比较并未显著增加恶心呕吐等不良反应的发生率。 结论： 右美托咪定作为肝肿瘤射频消融术患者镇痛镇静的基础用药，安全有效。.
Keywords: Ablation techniques; Dexmedetomidine; Liver neoplasms; Validation studies.