右美托咪定用于腰椎手术控制性降压效果及对术后认知功能的影响  

Effect of dexmedetomidine on controlled hypotension and postoperative cognitive function in lumbar surgery

作　　者：邓小兵 黄乐林 肖华平[2] DENG Xiao-bing;HUANG Le-lin;XIAO Hua-ping(171th Hospital,Jiujiang PLA Lushan Rehabilitation and Sanatorium Center,Jiujiang 332000,China;Jiangxi Provincial Cancer Hospital,Nanchang 330029,China)

机构地区：[1]江西省九江市解放军庐山康复疗养中心第171医院,江西九江332000 [2]江西省肿瘤医院,江西南昌330029

出　　处：《广东医科大学学报》2021年第4期443-446,共4页Journal of Guangdong Medical University

摘　　要：目的观察右美托咪定用于腰椎手术控制性降压效果及对术后认知功能的影响。方法100例行腰椎手术患者随机分为观察组与对照组,分别在诱导后注射右美托咪定或0.9%氯化钠溶液;比较两组麻醉诱导前(T0)、麻醉诱导后(T1)、手术结束即刻(T2)、气管拔管后(T3)时平均动脉压(MAP)、心率(HR)脑氧代谢水平、苏醒质量等,术后24 h(T4)、48 h(T5)、72 h(T6)以及7 d(T7)认知功能情况。结果观察组T3时MAP和HR值,T1、T2、T3时动脉-颈内静脉球部血氧差[D(a-jv)O_(2)],脑氧摄取量(CEO_(2))水平与苏醒后躁动评分均低于同期对照组(P<0.05);T4、T5、T6时认知功能评分高于对照组,拔管时间、苏醒时间长于对照组(P<0.05)。结论右美托咪定可安全用于腰椎手术控制性降压,降低围术期脑代谢,改善术后认知功能。Objective To observe the effect of dexmedetomidine on controlled hypotension and postoperative cognitive function in lumbar surgery.Methods A total of 100 patients undergoing lumbar surgery were randomly divided into observation and control groups,each receiving intravenous dexmedetomidine or normal saline after anesthetic induction.Mean arterial pressure(MAP),heart rate(HR),cerebral oxygen metabolism,resuscitation,and cognitive function were compared between 2 groups pre-induction(T0),post-induction(T1),immediately after surgery(T2),after tracheal extubation(T3),and 24 h(T4),48 h(T5),72 h(T6),7 d(T7)post-operation.Results Compared with control group,MAP and HR at T3,and arterial-jugular venous oxygen difference[D-(a-jv)O_(2)],cerebral oxygen extraction(CEO_(2))and postawakening agitation score at T1-T3 were lower(P<0.05),while cognitive function scores and extubation and recovery time were higher(P<0.05)in observation group.Conclusion Dexmedetomidine is safe for controlled hypotension during lumbar surgery,and can reduce perioperative cerebral metabolism and improve postoperative cognitive function.

关 键 词：腰椎手术 右美托咪定 控制性降压 认知功能 

分 类 号：R541[医药卫生—心血管疾病]