右美托咪定对颅内肿瘤手术患者血流动力学的影响及脑保护作用  

Effect of dexmedetomidine on hemodynamics and neuroprotection in patients undergoing brain tumor surgery

作　　者：陈晓梅[1] 陈广福[1] 

机构地区：[1]福建省福州市第二医院麻醉科,350007

出　　处：《临床麻醉学杂志》2015年第1期15-17,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨右美托咪定对颅内肿瘤手术患者血流动力学的影响及对患者脑保护的作用。方法将60例择期行颅内肿瘤手术患者随机分为右美托咪定组和对照组,每组30例。右美托咪定组患者诱导后静脉注射右美托咪定1μg/kg,10min注射完毕,术中持续静脉泵注右美托咪定0.4μg·kg^-1·h^-1。对照组诱导后给予等量生理盐水。记录两组患者入室后（T0）、给药后（T1）、插管时（T2）、苏醒时（T3）、拔管时（T4）、出手术室（T5）的SBP、DBP、MAP及HR。并检测T0、手术完成（T6）、术后6h（T7）、术后12h（T8）和术后24h（T9）的血清S100β和NSE水平。结果与对照组比较,右美托咪定组T1～T5时SBP、DBP和MAP明显降低,HR明显减慢（P〈0.05）。与T0时比较,右美托咪定组T1～T5点MAP水平明显降低（P〈0.05）。与T0时比较,两组T6～T9时S100β和NSE水平明显增高（P〈0.05）。与对照组比较,右美托咪定组T6～T9时血清S100β和NSE水平明显降低（P〈0.05）。结论右美托咪定可较好维持颅内肿瘤患者术中血流动力学的稳定,术中、术后24h内S100β和NSE水平较低。Objective This study was to investigate the effect of dexmedetomidine on hemodynamics and neuroprotection in patients undergoing brain tumor surgery.Methods Sixty patients scheduled for brain tumor surgery were randomly divided into the dexmedetomidine group and the control group（n=30）.Patients in the dexmedetomidine group were given intravenous dexmedetomidine（1μg/kg）after the induction and a continuous dexmedetomidine（0.4μg·kg^-1·h^-1）infusion.Patients in the control group were given the same amount of saline.The SBP,DBP,MAP and HR in two groups were recorded before the anesthesia（T0）,after the drug administration（T1）,during the intubation（T2）,at the emergence（T3）,during the extubation（T4）,and at the time of leaving operating room（T5）.The serum S100βand NSE levels in two groups were assessed at T0,the completion of surgery（T6）,6hafter surgery（T7）,12 hafter surgery（T8）and 24 hafter surgery（T9）.Results Compared to the control group,the SBP,DBP,MAP and HR levels in the dexmedetomidine group were significantly decreased at time point of T1-T5（P〈0.05）.Compared to the time point of T0,the MAP in the dexmedetomidine group at time point of T1-T5 were significantly decreased（P〈0.05）.Compared to time point of T0,the serum S100βand NSE levels in two groups at time point of T6-T9 were significantly increased.The expression of S100βand NSE in the dexmedetomidine group at time point of T6-T9 were significantly decreased when compared with the control group（P〈0.05）.Conclusion Dexmedetomidine can effectively maintain a stable hemodynamic,and regulate the serum S100βand NSE levels to protect the patient brain.

关 键 词：右美托咪定 颅内肿瘤 血流动力学 脑保护 

分 类 号：R739.41[医药卫生—肿瘤] R614[医药卫生—临床医学]