摘要
目的探讨右美托咪定在颅脑外伤患者围手术期的脑保护作用。方法静脉全身麻醉下行颅脑外伤手术患者43例随机分为两组:Dex组22例,麻醉诱导前10min静脉输注右美托咪定1μg/kg,随后以0.4μg·kg^(-1)·h^(-1)泵注至术后72h;对照组21例,术后给予丙泊酚镇静作为对照。于麻醉诱导即刻、手术1h、术毕和术后72h行动脉和颈内静脉球部血气分析。比较两组术后脑组织氧摄取率(CERO_2)和动-静脉血氧含量差(Da-jvO_2),检测血清微小RNA(miR)-20a和miR^(-1)95的变化。结果术后72h,Dex组的Da-jvO_2和CERO_2均高于对照组[(41±8)ml/L vs.(39±9)ml/L和(32±6)%vs.(30±5)%](P<0.05),血清miR-20a和miR^(-1)95水平均低于对照组(P<0.05)。结论右美托咪定用于颅脑外伤患者围手术期镇静安全、有效,具有一定的脑保护作用。
Objective To investigate the cerebral protection of dexmedetomidine in the patients with traumatic brain injury.Methods Forty-three patients with traumatic brain injury were operated under general anesthesia and randomly assigned into two groups.The patients in group D（22cases）were infused dexmedetomidine 1μg/kg in 10 minutes before anesthesia induction,which was followed by pumping dexmedetomidine 0.4μg·kg^-1·h^-1 untill 72 hours after surgery.The patients in group C（21cases）were infused propofol as the controls.The blood samples from artery and internal jugular vein bulb were taken before anesthesia induction（T0）,at one hour of operation（T1）,at the end of operation（T2）and 72 hours after operation（T3）for the blood gas analysis.Cerebral extraction ratio for oxygen（CERO2）and arterovenous blood oxygen difference（Da-jvO2）were calculated.Serum microRNA（miR）-20 aand miR^-195 were detected as well.Results The Da-jvO2 and CERO2 at T3 were higher in group D than those in group C[（41±8）ml/L vs.（39±9）ml/L and（32±6）% vs.（30±5）%]（P〈0.05）.Serum levels of miR-20 aand miR^-195 at T3were lower in group D than those in group C（P〈0.05）.Conclusion Dexmedetomidine has cerebral protection effect and can be used safely and effectively for postoperative sedation in the patients with traumatic brain injury.
出处
《江苏医药》
CAS
2017年第3期193-195,共3页
Jiangsu Medical Journal
关键词
右美托咪定
颅脑损伤
脑保护
Dexmedetomidine
Traumatic brain injury
Neuroprotection
