摘要
目的观察体外循环期间右美托咪定对体循环阻力的影响。方法选择2012年1月-4月风湿性心脏病行二尖瓣置换术的患者31例,美国麻醉医师协会分级Ⅱ或Ⅲ级,心功能Ⅱ或Ⅲ级,年龄35～60岁,随机分为试验组（n=16）和对照组（n=15）,心脏停跳后保持灌注流量2.4 L/（min·m^2）,中度低温体外循环。试验组经贮血器静脉端泵入右美托咪定（1.0μg/kg）10 min,继以0.5μg/（kg·min）持续输注;对照组则泵入等容量生理盐水。分别记录两组给药前（T0,基础值）及给药后10 min（T1）、20 min（T2）时的平均动脉压（MAP）和外周循环阻力（SVR）,并测定对应时点血浆皮质醇、肾上腺素和去甲肾上腺素的浓度。结果与T0比较,试验组T1、T2时MAP、SVR下降,对照组MAP、SVR升高（P〈0.05）,两组T1、T2时点MAP、SVR比较,差异有统计学意义（P〈0.05）;试验组T1、T2时点血浆皮质醇、肾上腺素、去甲肾上腺素较术前下降,对照组则较术前上升,两组间T1、T2时点血浆皮质醇、肾上腺素、去甲肾上腺素差异有统计学意义（P〈0.05）。结论体外循环期间应用右美托咪定可以降低SVR,减轻应激反应。
Objective To investigate the effect of dexmedetomidine on systemic vascular resistance in patients undergoing cardiopulmonary bypass. Methods Thirty-one patients undergoing cardiac surgery with cardiopulmonary bypass from January to April, 2012 were randomized into experimental group（n=16） and control group（n=15）. The flow rate was kept at 2.4 L/（min·m^2） and moderate hypothermia was maintained. Equivalent dexmedetomidine and 0.9% sodium chloride solution were pumped for the experimental group and control group, respectively. The mean artery pressure（MAP）, systemic vascular resistance（SVR）, Cortisol, epinephrine and norepinephrine were determined before（T0） and at 10 and 20 minutes（T1,T2） after dexmedetomidine administration. Results Compared with T0, there were significant decreases in MAP and SVR at T1 and T2（P〈0.05）. MAP and SVR were significantly lower in the experimental group than in the control group at T1 and T2, respectively（P〈0.05）; cortisol, epinephrine and norepinephrine were significantly lower in the experimental group than in the control group at T1 and T2, respectively（P〈0.05）. Conclusions Dexmedetomidine reduces SVR and causes decrease in MAP. It can effectively inhibit the stress reaction in patients undergoing cardiopulmonary bypass.
出处
《华西医学》
CAS
2014年第8期1504-1507,共4页
West China Medical Journal
关键词
右美托咪定
心肺转流术
血管阻力
Dexmedetomidine
Cardiopulmonary bypass
Vascular resistance
