右美托咪定对脑胶质瘤切除术患者神经损伤的影响  

Effect of dexmedetomidine on nerve injury in patients undergoing glioma resection

作　　者：王琦[1] 于红美[1] 于红[1] 马美娜[1] 马亚利 李睿[1] Wang Qi;Yu Hongmei;Yu Hong;Ma Meina;Ma Yali;Li Rui(Department of Anesthesiology,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院脑科医院麻醉科,061000

出　　处：《中华麻醉学杂志》2019年第12期1430-1432,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价右美托咪定对脑胶质瘤切除术患者神经损伤的影响。方法择期行全麻下脑胶质瘤切除术患者70例,性别不限,年龄18~60岁,BMI 18~25 kg/m^2,ASA分级Ⅰ或Ⅱ级。采用随机数字表法分为2组(n=35):对照组(C组)和右美托咪定组(DEX组)。DEX组于麻醉诱导前20 min内经外周静脉输注右美托咪定0.8μg/kg,C组给予等容量生理盐水。于麻醉诱导前、切开硬脑膜即刻、切除肿瘤即刻、手术结束即刻、气管拔管即刻、术后1和24 h(T0-6)时采集肘部静脉血样,采用电化学发光法检测血浆NSE浓度,放射免疫发光法检测神经肽Y(NPY)浓度,ELISA法检测血浆可溶性血管细胞间黏附分子(sVCAM-1)浓度。结果与T0时比较,C组T1-6时、DEX组T1-5时血浆sVCAM-1、NSE和NPY浓度升高(P<0.05);与C组比较,DEX组T1-6时血浆sVCAM-1、NSE和NPY浓度降低(P<0.05)。结论右美托咪定可有效减轻脑胶质瘤切除术患者神经损伤。Objective To evaluate the effect of dexmedetomidine on nerve injury in the patients undergoing glioma resection.Methods Seventy patients of both sexes,aged 18-60 yr,with body mass index of 18-25 kg/m^2,of American Society of Anesthesiologists physical statusⅠorⅡ,scheduled for elective glioma resection with general anesthesia,were divided into 2 groups(n=35 each)using a random number table method:control group(group C)and dexmedetomidine group(group DEX).Dexmedetomidine 0.8μg/kg was infused over 20 min before induction of anesthesia in group DEX,while the equal volume of normal saline was given instead in group C.Before induction of anesthesia(baseline),immediatiely after the brain was opened,immediatiely after beginning of tumor removal,immediatiely after the end of operation,immediatiely after the end of tracheal extubation,and at 1 and 24 h after operation(T0-6),venous blood samples were taken to determine the concentrations of serum neuron-specific enolase(NSE),neuropeptide Y(NPY)and soluble vascular cell adhesion molecule-1(sVCAM-1).Results Compared with the baseline at T0,the concentrations of serum sVCAM-1,NSE and NPY at T1-6 in group C and at T1-5 in group DEX were significantly increased(P<0.05).The concentrations of serum sVCAM-1,NSE and NPY were significantly lower at T1-6 in group DEX than in group C(P<005).Conclusion Dexmedetomidine can effectively reduce nerve injury in the patients undergoing glioma resection.

关 键 词：右美托咪啶 脑肿瘤 神经损伤 

分 类 号：R614[医药卫生—麻醉学] R73[医药卫生—外科学]