[摘要] 目的 觀察右美托咪定在經(jīng)皮穿刺頸椎后路內(nèi)鏡下髓核摘除術(shù)中的應用效果。 方法 選擇2016年3月～2017年11月我科收治的擬行經(jīng)皮穿刺頸椎后路內(nèi)鏡下髓核摘除術(shù)頸椎病患者42例，隨機分為右美托咪定組（D組）和安慰劑組（N組）。D組術(shù)中泵注右美托咪定，N組泵注生理鹽水；兩組術(shù)中均予利多卡因局麻。記錄基礎(chǔ)值（T1）、建立工作通道（T2）、打磨椎板、顯露神經(jīng)根（T3）、取髓核（T4）、術(shù)畢（T5）時的心率（HR）、平均動脈壓（MAP）、血氧飽和度（SpO2）及警覺/鎮(zhèn)靜（OAA/S）評分，記錄術(shù)中的不良反應、手術(shù)配合情況和患者滿意度。 結(jié)果 D組T2、T3、T4時的HR、MAP和OAA/S評分，與N組比較差異有統(tǒng)計學意義（P<0.05）；D組T2、T3、T4時的OAA/S評分與T1、T5時比較，差異有統(tǒng)計學意義（P<0.05）。兩組術(shù)中無不良反應發(fā)生。D組患者手術(shù)配合情況和患者滿意度與N組比較，差異有統(tǒng)計學意義（P<0.05）。 結(jié)論 右美托咪定用于經(jīng)皮穿刺頸椎后路內(nèi)鏡下髓核摘除術(shù)治療神經(jīng)根型頸椎病安全、有效。
　　[關(guān)鍵詞] 右美托咪定；頸椎��；內(nèi)鏡；局部麻醉
　　[中圖分類號] R614.3 [文獻標識碼] B [文章編號] 1673-9701（2018）08-0108-04
　　Application of dexmedetomidine in endoscopic discectomy with percutaneous needle posterior cervical spine
　　SHEN Bangli1 GONG Gonghao1 XU Feng1 HUANG Xixi1 WANG Peifang1 LIU Huacheng2 HUANG Xiaofang3
　　1.Department of Pain，the Second Affiliated Hospital of Wenzhou Medical University，Wenzhou 325027，China；2.Department of Anesthesiology，the Second Affiliated Hospital of Wenzhou Medical University，Wenzhou 325027，China；3.Department of Catheter Interventional Room，the Second Affiliated Hospital of Wenzhou Medical University，Wenzhou 325027，China
　　[Abstract] Objective To observe the effect of dexmedetomidine in endoscopic discectomy by percutaneous pinning of posterior cervical spine. Methods From March 2016 to November 2017， 42 patients with cervical spondylotic myelopathy who underwent endoscopic percutaneous cervical discectomy who underwent percutaneous puncture in our department were randomly divided into two groups： Dexmedetomidine group（D group）and placebo group（N group）. Group D was intramuscularly injected with dexmedetomidine， and group N was infused with normal saline. Both groups were given local anesthesia with lidocaine. The basic values （T1）， working channel（T2）， laminectomy， nerve root（T3）， nucleus pulposus（T4）， heart rate（HR） and mean arterial pressure（MAP）SpO2， and OAA/S scores were recorded. The adverse reactions， surgical cooperation and patient satisfaction were recorded. Results The scores of HR， MAP and OAA/S at T2， T3 and T4 in group D were significantly different from those in group N（P<0.05）. The scores of OAA/S at T2， T3 and T4 in group D were significantly higher than those in group T1 ， T5， the difference was statistically significant（P<0.05）. No adverse reactions occurred during operation in both groups. Compared with N group， the difference of operation cooperation and patient satisfaction in group D was statistically significant（P<0.05）. Conclusion Dexmedetomidine is safe and effective in treating cervical spondylotic radiculopathy due to endoscopic cervical discectomy with percutaneous puncture.

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