咪达唑仑联合右美托咪定对脑出血微创术后患者近期应激指标的影响  

Effects of midazolam combined dexmedetomidine on the recent stress index of patients with cerebral hemorrhage minimally invasive surgery

作　　者：马汤力[1] 张冬惠[1] 王绍谦[1] 杨胜[1] 

机构地区：[1]开封市第二人民医院急诊科,河南开封475000

出　　处：《泰山医学院学报》2017年第8期876-878,共3页Journal of Taishan Medical College

摘　　要：目的通过观察脑出血微创术后患者近期应激指标的变化,旨在探讨咪达唑仑联合右美托咪定对脑出血术后应激指标的影响。方法选择2015年1月至2016年5月在我院EICU住院的90例行脑出血微创钻孔引流术后的患者,随机分为A组(阴性对照组)22例、B组(咪达唑仑组)23例、C组(右美托咪定组)23例,D组(咪达唑仑联合右美托咪定组)22例。观察4组患者术毕、术后12 h、术后24 h、术后48 h的β内啡肽(β-EP)和S100蛋白b(S100b)、神经元特异性烯醇化酶(NSE)、血糖(GLU)各时间点的测定值的变化。结果 4组患者于术后入住EICU时时间节点基础值水平比较无明显差异(P>0.05);4组患者于术后入住EICU 12 h、24 h、48 h三个时间节点比较,差异有显著性意义(P<0.05);4组在入住EICU后12 h时间节点,B、C和D组血糖相对于A组患者比较,差异有显著性意义(P<0.05)。结论咪达唑仑、右美托咪定都可以降低脑出血术后患者的β-EP、S100b、NSE、GLU等应激指标水平,右美托咪定降低应激指标数值程度优于咪达唑仑组,咪达唑仑联合右美托咪定组降低应激指标数值程度优于单独应用右美托咪定组和单独应用咪达唑仑组。Objective： To investigate the effect of midazolam combined with dexmedetomidine on the postoperative stress in patients with intracerebral hemorrhage （ICH）. Methods： 90 patients who underwent microinvasive drilling and drainage after intracerebral hemorrhage were randomly divided into two groups： group A （n = 22 ）, group B （n = 20） 23 patients in the midazolam group, 23 patients in the C group and 22 patients in the D group （midazolam plus dexmedetomidine group）. （13-EP）and S100b （S100b）, neuron-specific enolase （NSE）, blood glucose （GLU） were measured at the end of opera- tion, at 12 h, 24 h and 48 h after operation. At each time point. Results： There was no significant difference in the base- line level of EICU between the four groups （ P 〉 0. 05 ）. There were significant differences between the four groups in EICU at 12 hours, 24 hours and 48 hours （P 〈0.05）. Compared with group A, there were significant differences （P 〈0. 05） in blood glucose of group B, group C and group D at 12 hours after admission EICU. Conclusion： Midazolam and dexmedeto- midine can decrease the levels of 13-EP, S100b, NSE and GLU in the patients after intracerebral hemorrhage, and the value of dexmedetomidine to lower the stress index is better than that of Imidazole The degree of decrease of stress index in the combination of zolomun, midazolam and dexmedetomidine was better than that of dexmedetomidine alone or midazolam.

关 键 词：咪达唑仑 右美托咪定 脑出血微创术后 应激 

分 类 号：R614[医药卫生—麻醉学]