摘要
目的:评价右美托咪定对重症颅脑损伤患者围术期脑组织的保护作用,并探讨其对血清炎性因子的影响。方法:选取2017年5月至2018年11月拟行颅脑手术的重症颅脑损伤患者120例,按随机数字表法分为对照组和观察组,每组60例。对照组患者给予丙泊酚+罗库溴铵+咪达唑仑+芬太尼常规麻醉诱导,观察组患者在对照组基础上加用右美托咪定。比较两组患者的镇静情况,手术前后脑氧代谢指标、血清炎性因子水平及预后良好率的差异。结果:观察组患者镇静所需时间、机械通气时间明显短于对照组,芬太尼用量明显少于对照组,差异均有统计学意义(P<0.05)。术后72 h,两组患者的颈内静脉血氧饱和度明显高于术前,颈内动静脉血氧含量差、脑组织氧摄取率明显低于术前,且观察组患者上述指标水平均明显优于对照组,差异均有统计学意义(P<0.05);两组患者的血清C反应蛋白、肿瘤坏死因子α、白细胞介素6及白细胞介素8水平均明显高于术前,但观察组患者上述指标水平均明显低于对照组,差异均有统计学意义(P<0.05)。观察组的预后良好率明显高于对照组,差异有统计学意义(P<0.05)。结论:右美托咪定用于重症颅脑损伤患者手术,可提高麻醉效率,减少麻醉药用量,降低脑耗氧量,改善脑代谢紊乱状态,降低炎性因子水平,抑制炎症反应,改善患者预后。
OBJECTIVE:To evaluate the protection effect of dexmedetomidine on perioperative brain tissue in patients with severe craniocerebral injury,and probe into its effect on serum inflammatory factors.METHODS:120 patients with severe craniocerebral injury undergoing craniocerebral operations from May 2017 to Nov.2018 were selected and divided into control group and observation group via random number table,with 60 cases in each group.The control group was given propofol + rocuronium + midazolam + fentanyl for routine anesthesia induction,while the observation group were given dexmedetomidine based on the control group.Differences in sedation,cerebral oxygen metabolism indices,serum inflammatory factor level and prognosis rate between two groups before and after surgery were compared.RESULTS:The time required for sedation and average mechanical ventilation time of observation group were significantly shorter than those of the control group.And the dose of fentanyl of observation group was significantly lower than that of control group,with statistically significant differnces ( P <0.05).At 72 hours after operation,the jugular venous oxygen saturation of both groups were significantly higher than that of before operation,while the jugular arterial venous oxygen content difference and oxygen uptake rate of brain tissue were significantly lower than those of before operation,and those of the observation group were significantly better than the control group,with statistically significant differnces ( P <0.05);the serum C-reactive protein,tumor necrosis factor α,interleukin-6 and interleukin-8 levels of both groups were significantly higher than those of before operation,and those of the observation group was significantly lower than the control group,with statistically significant differnces ( P <0.05).The rate of favorable prognosis of observation group was significantly higher than that of the control group,with statistically significant differnces ( P <0.05).CONCLUSIONS:The application of dexmedetomidine in the operati
作者
宋贺
张花平
邱延伟
张栋梁
苏现辉
SONG He;ZHANG Huaping;QIU Yanwei;ZHANG Dongliang;SU Xianhui(Neurological ICU,the First Hospital of Shijiazhuang,Hebei Shijiazhuang 050000,China;Dept.of Anesthesiology,the First Hospital of Shijiazhuang,Hebei Shijiazhuang 050000,China;Dept.of Neurosurgery,the First Hospital of Shijiazhuang,Hebei Shijiazhuang 050000,China)
出处
《中国医院用药评价与分析》
2019年第5期530-533,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
河北省重点研发计划自筹项目-健康医疗与生物医药专项(No.172777195)
关键词
右美托咪定
重症颅脑损伤
手术
脑组织保护
炎性因子
Dexmedetomidine
Severe craniocerebral injury
Operation
Brain tissue protection
Inflammatory factor
