摘要
目的探讨右美托咪定联合丙泊酚全凭静脉麻醉对幕上肿瘤切除术患者脑氧供需平衡和能量代谢的影响。方法选取医院2015年2月至2017年1月收治的幕上肿瘤切除术患者82例,依据麻醉方法的不同分为对照组(40例)和观察组(42例),对照组患者接受丙泊酚联合芬太尼麻醉,观察组患者实施右美托咪定联合丙泊酚全凭静脉麻醉。结果观察组丙泊酚用量、Ramsay镇静评分较对照组明显少/高,麻醉起效时间较对照组明显缩短(P <0. 05);麻醉诱导前(T0),两组患者动脉血氧含量(CaO2)、颈静脉球部血氧饱和度(SjvO2)、颈内静脉血氧含量(CjvO2)、脑氧摄取率(CERO2)、葡萄糖摄取率(GluER)、脑乳酸生成率(LacPR)、脑乳酸氧指数(LOI)比较无明显差异(P> 0. 05);与T0时刻比较,对照组患者CaO2,SjvO2,CjvO2,GluER,LacPR,LOI明显降低,CERO2明显升高;手术结束即刻(T1)、术后24 h(T2),对照组患者各项指标变化幅度明显大于观察组患者(P <0. 05);术后1,3,5个月,两组患者生活质量评分(QOL)明显升高,且观察组患者升高幅度更明显(P <0. 05);观察组麻醉药品不良反应发生率为11. 90%,明显低于对照组的45. 00%(χ2=11. 119,P <0. 05)。结论右美托咪定联合丙泊酚全凭静脉麻醉应用于幕上肿瘤切除术,有利于患者脑氧供需平衡和能量代谢,临床效果好,预后佳,安全性高,值得临床推广。
Objective To investigate the effect of total intravenous anesthesia with dexmedetomidine combined with propofol on cerebral oxygen supply - demand balance and energy metabolism in patients undergoing supratentorial tumor resection. Methods Totally 82 patients undergoing supratentorial tumor resection admitted to our hospital from Februmy 2015 to Janumy 2017 were selected and divided into the control group( n =40) and the observation group( t~ =42) according to different anesthesia methods. The control group was given anesthesia with fentanyl and propofol, while the observation group was given total intravenous anesthesia with dexmedetomidine and propofol. Results The dosage of propofol and the Ramsay sedation score in the observation group were less / higher than those in the control group,and the onset time of anesthesia in the observation group was shorter than that in the control group(P 〈 0. 05). Before induction of anesthesia(T0),there was no significant difference in arterial oxygen content(CaO2),jugular venous oxygen saturation(SjvO2), internal jugular venous oxygen content(CjvO2),cerebral oxygen extraction rate(CERO2),glucose extraction rate(GluER),cerebral lactate production rate(LacPR) and cerebral lactate oxygen index(LOI) between the two groups(P 〉 0. 05). Compared with T0,the levels of CaO2,SjvO2, CjvO2, GluER,LacPR and LOI in the control group were significantly decreased,while the level of CERO2 in the control group was significantly increased,and the changes in the control group at the end of surgmy(T1) and at 24 h after operation(T2) were more significant than those in the observation group(P 〈 0.05). 1 month,3 months and 5 months after operation,the quality of life (QOL) scores of the two groups increased significantly,and the increase in the obsrvation group was more significant than that in the control group(P 〈 0.05).The incidence rate of adverse drug reactions in the observation group was 11.90% ,which was significan
作者
刘勇攀
Liu Yongpan(Department of Anesthesiology,Shiyan Taihe Hospital,Shiyan,Hubei,China 44200)
出处
《中国药业》
CAS
2018年第22期67-69,共3页
China Pharmaceuticals
关键词
右美托咪定
丙泊酚
幕上肿瘤切除术
全凭静脉麻醉
脑供氧
能量代谢
dexmedetomidine
propofol
supratentorial tumor resection
total intravenous anesthesia
cerebral oxygen supply
energT metabolism