右美托咪啶对非体外循环冠状动脉旁路移植术中心肌保护的影响  

The myocardial protection effect of dexmedetomidine in non-pump coronary artery bypass grafting

作　　者：赵海涛[1] 李亮[1] 蔡勤芳[1] 田冶[1] 曹福羊[1] 

机构地区：[1]解放军海军总医院麻醉科,北京100048

出　　处：《中国临床医生杂志》2014年第3期21-22,26,共3页Chinese Journal For Clinicians

摘　　要：目的观察右美托咪啶（ Dex）对非体外循环冠状动脉旁路移植术（ OPCABG）患者围术期心肌损伤的保护作用。方法选择行OPCABG的患者60例（ ASAII~Ⅲ级,心功能II~Ⅲ级）,随机双盲分为Dex组（D组,输注Dex）和空白对照组（C组,输注0.9%的氯化钠溶液）各30例,分两个阶段给药,先以1μg/（kg·h）经微量注射泵静注给药15分钟,随后以0.5μg/（kg·h）维持给药至手术结束。分别于入室后（ T0）,血管吻合完毕（ T1）,术后6、12、24小时（ T2、T3、T4）抽取中心静脉血,测定IMA和 cTnI。结果两组患者入室后IMA、cTnI比较差异无统计学意义（P〉0.05）,D组在血管吻合完毕,术后6、12小时IMA均显著低于C组（P〈0.01）,术后6、12、24小时cTnI均显著低于C组（P〈0.05）。结论右美托咪啶能稳定血流动力学,减轻非体外循环冠状动脉旁路移植术患者围术期心肌损伤,对心肌具有一定的保护作用。Objective To observe the myocardial protection effect of dexmedetomidine in off-pump coronary artery bypass grafting （ OPCABG） . Method 60 patients （ American Society of AnesthesiologistsII~Ⅲ, cardiac function grade II~Ⅲ） who suffered OPCABG were randomly divided into Dex group （group D, infusion of Dex,n=20） and control group （ group C, infusion of normal saline,n=20） . The drugs were given by two stages：first injection at 1μg/（kg·h）for 15 min, and then maintained at 0. 5μg/（kg·h）. IMA and cTnI were determined with the central venous bleed that extracted after the burglary （ T0 ） , at ascular anastomosis completed （ T1 ） , 6、12、24 h at postoperative （ T2、T3、T4 ） , respectively. Result The difference of IMA and cTnIafter the burglary （ T0 ） were not statistically significant（P〉0. 05）. After vascular anastomosis has completed, IMA after postoperative 6、12 h in group D were significantly lower than C group （P〈0. 01）, cTnIafter postoperative 6、12、24 h in group D were sig-nificantly lower than C group （P〈0. 05）. Conclusion Dexmedetomidine has obvious protective effect on the myo-cardium, it can stable hemodynamics, reduce OPCABG in patients with perioperative myocardial damage.

关 键 词：右美托咪啶 非体外循环冠状动脉旁路移植术 心肌保护 

分 类 号：R654.2[医药卫生—外科学]