摘要
目的分析行体外循环(CPB)心脏瓣膜置换术患者采用不同剂量右美托咪定对手术结局及心肌损伤情况的影响。方法选取我院2021年1月至12月收治的202例行CPB心脏瓣膜置换术患者作为研究对象,并以右美托咪定使用剂量将其分为0.2μg组(101例,0.2μg右美托咪定)和0.4μg组(101例,0.4μg右美托咪定)。比较两组的麻醉效果。结果两组患者的CPB时长、主动脉阻断时长和心脏自动复跳率比较,差异无统计学意义(P>0.05)。术前及术后,两组的脑利钠肽(BNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、可溶性生长刺激表达基因2蛋白(sST2)、心型脂肪酸结合蛋白(hFABP)水平比较,差异均无统计学意义(P>0.05)。两组患者的术中心动过缓、低血压、呼吸抑制和术后头晕发生率比较,差异无统计学意义(P>0.05);0.4μg组的术后恶心呕吐、认知障碍发生率显著高于0.2μg组(P<0.05)。结论对行CPB心脏瓣膜置换术患者采用0.2μg右美托咪定进行手术麻醉可取得更佳的手术预后保障。
Objective To analyze the effects of different doses of dexmedetomidine on surgical outcome and myocardial injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods A total of 202 patients undergoing cardiac valve replacement with CPB in our hospital from January to December 2021 were selected as the research objects,and the patients were divided into 0.2μg group(101 cases,0.2μg dexmedetomidine)and 0.4μg group(101 cases,0.4μg dexmedetomidine)according to the dose of dexmedetomidine.The anesthetic effects of the two groups were compared.Results There were no significant differences in CPB duration,aortic occlusion duration and automatic heart resuscitation rate between the two groups(P>0.05).Before and after operation,there were no significant differences in the levels of brain natriuretic peptide(BNP),creatine kinase MB(CK-MB),cardiac troponin T(cTnT),soluble growth stimulation expressed gene 2 protein(sST2)and heart-type fatty acid binding protein(hFABP)between the two groups(P>0.05).There were no significant differences in the incidences of intraoperative bradycardia,hypotension,respiratory depression and postoperative dizziness between the two groups(P>0.05);the incidence of postoperative nausea and vomiting and cognitive impairment in the 0.4μg group were significantly higher than those in the 0.2μg group(P<0.05).Conclusion The use of 0.2μg dexmedetomidine for surgical anesthesia in patients undergoing cardiac valve replacement with CPB can achieve better surgical prognosis.
作者
甄万里
朱雅萍
宋磊军
金戈
ZHEN Wanli;ZHU Yaping;SONG Leijun;JIN Ge(Anesthesiology Department,the 7th People's Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《临床医学研究与实践》
2024年第6期92-95,共4页
Clinical Research and Practice
关键词
心脏瓣膜置换术
右美托咪定
体外循环
手术结局
心肌损伤
cardiac valve replacement
dexmedetomidine
cardiopulmonary bypass
surgical outcome
myocardial injury
