摘要
目的 评价不同剂量的右美托咪定对脑肿瘤切除术患儿的脑保护效应。方法 对行择期脑胶质瘤和脑膜瘤切除术的80例患儿进行研究分析,随机分成4组:对照组(N组),Dex1组(D1组),Dex2(D2组),Dex3组(D3组)。麻醉诱导前10min,D1、D2、D3组分别静脉输注右美托咪定负荷量1μg/kg,后维持剂量分别为右美托咪定0.4、0.7、1.0μg/(kg·h),N组静脉输注等容量的生理盐水。均以丙泊酚、瑞芬太尼、顺阿曲库铵维持麻醉,维持BIS值40~60之间。在术前24h(T0)、切开硬脑膜时(T1)、手术结束时(T2)及术后24h(T3)采集中心静脉血液,采用ELISA法测定S100β蛋白和NSE浓度。结果 (1)与T0时相比,N、D1、D2和D3组T1时的S100β蛋白浓度差异无统计学意义,T2、T3时的S100β蛋白浓度升高[(2.2±0.7),(2.7±0.5),(1.9±0.5),(2.2±0.3),(1.8±0.6),(2.1±0.5),(1.9±0.5),(2.3±0.4)](P〈0.05);T2、T3时,与N组对比,D1、D2、D3 3组的S100β蛋白浓度差异有统计学意义[(1.9±0.5),(2.2±0.3),(1.8±0.6),(2.1±0.5),(1.9±0.5),(2.3±0.4)](P〈0.05);D1、D2、D3 3组之间比较T2、T3时的S100β蛋白浓度差异无统计学意义。(2)与T0时相比,N、D1、D2和D3组T1时的NSE浓度差异无统计学意义,T2、T3时的NSE浓度升高[(5.5±1.0),(7.4±1.2),(4.3±0.7),(5.6±1.1),(4.4±0.7),(5.7±1.3),(4.2±0.7),(5.9±1.2)](P〈0.05);T2、T3时,与N组对比,D1、D2、D3 3组的NSE浓度差异有统计学意义[(4.3±0.7),(5.6±1.1),(4.4±0.7),(5.7±1.3),(4.2±0.7),(5.9±1.2)(P〈0.05);D1、D2、D3 3组之间比较T2、T3时的NSE浓度差异无统计学意义。(3)D1、D2、D3组患儿的苏醒时间及拔除气管导管时间明显低于N组患者,组间差异有统计学意义[(34±7),(39±7);(33±5),(38±6);(35±5),(38±5)](P<0.05);D1、D2
Objective To evaluate the neuroprotective effect of different doses of dexmedetomidine during periopererative period in children patients with brain neoplasms. Methods Eighty children patients with brain glioma and meningioma scheduled for elective intracranial tumor recection were randomly divided into 4 groups: control group (group N); Dex1 group (group D1); Dex2 group (group D2); Dex3 group (group D3). Dex1μg/kg was infused i.v.10 min before anesthesia induction, and then was infused at a rate of 0.4μg/(kg·h) (group D1)and 0.7μg/(kg·h) (group D2) and 1.0μg/(kg·h) (group D3). Group N received the equal volume of normal saline. Anesthesia was maintained with propofol, remifentanil and cisatracurium. Bispectral Index (BIS) was maintained at 40-60. Venous blood samples were taken 24h before operation (T0), while the endocranium was cut open (T1), at the end of the surgery (T2), and 24 h after operation (T3) for determination of serum concentrations of S100β and neuron-specific enolase(NSE) by ELISA method. Results (1)Compared with T0, there was no statistical difference in the concentration of S100β in serum among the four groups at T1, the concentration of S100β in serum were significantly increased at T2 and T3 in the four groups [(2.2±0.7), (2.7±0.5), (1.9±0.5), (2.2±0.3), (1.8±0.6), (2.1±0.5), (1.9±0.5), (2.3±0.4) ] (P〈0.05). Compared with group N, there was statistical difference in the concentration of S100β in serum among group D1, D2 and D3 at T2 and T3 [(1.9±0.5), (2.2±0.3), (1.8±0.6), (2.1±0.5), (1.9±0.5), (2.3±0.4) ] (P〈0.05). There was no statistical difference in the concentration of S100β in serum among group D1, D2 and D3 at T2 and T3. (2)Compared with T0, there was no statistical difference in the concentration of NSE in serum among the four groups at T1, the concentration of NSE in serum were significantly increased at T2 and T3 in
出处
《当代医学》
2016年第26期3-4,共2页
Contemporary Medicine
基金
河南省郑州市科技发展计划(20150157)
河南省医学科技攻关计划项目(201503227)
关键词
右美托咪定
小儿
脑肿瘤切除术
脑保护
Dexmedetomidine
Children
Brain neoplasms resection
Neuroprotection