摘要
目的探讨使用右美托咪定对体外循环(CPB)下行心脏瓣膜置换术患者脑组织损伤的保护作用。方法选取CPB下行心脏瓣膜置换术患者60例,分为观察组和对照组,分别给予右美托咪定和生理盐水,在CPB前(T1)、升主动脉开放(T2)、CPB结束(T3)及手术结束后6h(T4)测定颈内静脉球血氧饱和度(SjvO2)、脑动-颈内静脉血氧含量差(Ca-jvO2)、动脉血氧饱和度(PaO2)和脑氧摄取率(ERO2),并测定血浆S-100β蛋白和血浆特异性烯醇化酶(NSE)。结果在T2、T3时,SjvO2、PaO2均升高,Ca-jvO2、ERO2均降低,在T3复温时,观察组SjvO2、PaO2明显高于对照组,Ca-jvO2、ERO2较对照组低,两组比较差异有统计学意义(P<0.05)。在T2、T3、T4时,NSE浓度与S-100β蛋白水均升高,但观察组明显低于对照组,两者比较差异有统计学意义(P<0.05)。结论右美托咪定具有脑保护作用。
Objective To investigate protective effect of dexmedetomidine on cerebral injury in patients undergoing heart valve replacement surgery under cardiopulmonary bypass （CPB） .Methods 60 patients with CPB underwent cardiac valve replacement were randomly divided into observation group and control group ,and respectively given dexmedetomidine and saline ,before CPB （T1） ,aortic opening （T2） ,CPB （T3） and 6 hours after operation （T4） ,then tested jugular bulb oxygen saturation degree （SjvO2 ） , cerebral arteriovenous internal jugular venous oxygen content difference （Ca-jvO2 ）and cerebral oxygen extraction rate（ERO2 ） ,and the plasma levels of S-100βprotein and plasma specific enolase （NSE） .Results In T2 ,T3 ,SjvO2 ,PaO2 increased ,Ca-jvO2 ,ERO2 decreased ,in T3 during rewarming ,SjvO2 ,PaO2 of observation group was significantly higher than control group ,Ca-jvO2 ,ERO2 was lower than that in control group ,there were significant difference between two groups （P〈0 .05） .In T2 ,T3 ,T4 ,NSE and S-100βprotein concentration of water increased ,but that of observation group was significantly lower than that of control group ,there were significant differences between two groups （P〈0 .05） .Conclusion Dexmedetomidine has cerebral protective effect .
出处
《重庆医学》
CAS
CSCD
北大核心
2014年第1期67-68,71,共3页
Chongqing medicine
关键词
右美托咪定
心脏瓣膜置换术
脑损伤
dexmedetomidine
cardiac valve replacement
brain injury
