右美托咪定对体外循环心脏手术病人脑损伤的作用  

Effect of dexmedetomidine on brain injury in patients undergoing open heart surgery

作　　者：程毅坚[1] 唐建成[2] CHENG Yi-jian TANG Jian-cheng(Department of Anesthesiology, Sun Yat-sen Cardiovascular Hospital, Shenzhen, Guangdong 518020 Department of Anesthesiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, China)

机构地区：[1]深圳市孙逸仙心血管医院麻醉科,广东深圳518020 [2]广州医科大学附属第二医院麻醉科,广东广州510260

出　　处：《热带医学杂志》2017年第7期949-951,955,共4页Journal of Tropical Medicine

摘　　要：目的探讨右美托咪定用于预防病人脑损伤的可行性、有效性。方法选取2015年3月至2016年4月期间我院经诊断入院行体外循环心脏手术治疗的60例患者,本次临床分组采用双盲法随机分为对照组、观察组,每组30例。对照组给予常规麻醉,观察组在此基础上使用右美托咪定,对两组手术不同时间段患者脑损伤指标情况进行检测。结果 T1时刻对照组与观察组髓鞘碱性蛋白(MBP)、S100β、内皮素-1水平比较差异无统计学意义(P>0.05);T2、T3、T4时刻观察组MBP、S100β、内皮素-1水平显著低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率(6.6%)显著低于对照组(30.0%),差异有统计学意义(P<0.05)。结论临床对于行体外循环心脏手术者,可使用右美托咪定,减轻手术对脑组织的损害。Objective To investigate the feasibility and effectiveness of dexmedetomidine in prevention of brain injury in patients undergoing open heart surgery. Methods A total of 60 patients undergoing open heart surgery in our hospital during March 2015-April 2016 were divided into the control group and the observation group by double blind method ,30 patients in each group. The control group was given routine anesthesia;on this basis ,the observation group was treated with dexmedetomidine. The brain injury indexes in two groups were detected at different time. Results There was no significant difference in MBP,S100β and endothelial-1 levels between the two groups at T1（P〉0.05）. At T2,T3 and T4,the above levels were significantly lower in the observation group than th control group （P〈0.05）. The incidence of adverse reactions was significantly lower in the observation group than the control group （6.6% vs. 30.0%）（P〈0.05）. Conclusion Dexmedetomidine can be used to prevent brain injury in patients undergoing open heart surgery.

关 键 词：脑损伤 体外循环 右美托咪定 

分 类 号：R654.1[医药卫生—外科学]