右美托咪定在脑肿瘤切除术患者中的应用效果及其脑保护效应  

Application effect of dexmedetomidine in patients undergoing brain tumor resection and its brain protective effect

作　　者：武辉 吴玉亭 WU Hui;WU Yuting(Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院,陕西汉中723000

出　　处：《临床医学研究与实践》2023年第24期106-109,共4页Clinical Research and Practice

摘　　要：目的 研讨右美托咪定(Dex)在脑肿瘤切除术患者中的应用效果及其脑保护效应。方法 以随机数字表法将2019年2月至2021年3月入住我院且择期实施脑肿瘤切除术的60例患者分为观察组和对照组,每组30例。观察组麻醉诱导前予以Dex静脉输注,负荷剂量为1.0μg/kg,后以0.6μg/(kg·h)的速率持续泵注;对照组予以等量生理盐水输注。比较两组的血流动力学指标、脑损伤标志物、氧化应激指标及不良反应发生情况。结果 插管即刻(T_(1))~拔管时(T_(3)),观察组的平均动脉压(MAP)均高于对照组,心率(HR)均低于对照组(P<0.05)。硬脑膜切开后30 min(T_(5))~术后首日(T_(7)),观察组的中枢神经特异性蛋白(S100β)水平低于对照组(P<0.05);术毕5 min(T_(6))~T_(7)时,观察组的神经元特异性烯醇化酶(NSE)水平均低于对照组(P<0.05)。T_(6)~T_(7)时,观察组的超氧物歧化酶(SOD)水平高于对照组,丙二醛(MDA)水平低于对照组(P<0.05)。观察组的不良反应总发生率为10.00%,显著低于对照组的33.33%(P<0.05)。结论 Dex能够较好地维持脑肿瘤切除术患者的血流动力学稳定,且具有较好的脑保护效应与用药安全性,其机制可能与机体的氧化应激反应受到抑制有关。Objective To investigate the application effect of dexmedetomidine(Dex)in patients undergoing brain tumor resection and its brain protective effect.Methods Sixty patients who were admitted in our hospital from February 2019 to March 2021 and underwent elective brain tumor resection were divided into observation group and control group by random number table method,with 30 cases in each group.The observation group was given intravenous infusion of Dex before anesthesia induction,with a loading dose of 1.0μg/kg,followed by continuous pumping at a rate of 0.6μg/(kg·h).The control group was given the same amount of normal saline infusion.The hemodynamics indexes,brain injury markers,oxidative stress indexes and adverse reactions were compared between the two groups.Results At the time of intubation(T_(1))-extubation(T_(3)),the mean arterial pressure(MAP)of the observation group was higher than that of the control group,and the heart rate(HR)was lower than that of the control group(P<0.05).At 30 min after dural incision(T_(5))-the first day after operation(T_(7)),the level of central nervous system specific protein(S100β)in the observation group was lower than that in the control group(P<0.05).At 5 min after operation(T_(6))-T_(7),the level of neuron specific enolase(NSE)in the observation group was lower than that in the control group(P<0.05).At T_(6)-T_(7),the level of superoxide dismutase(SOD)in the observation group was higher than that in the control group,and the level of malondialdehyde(MDA)was lower than that in the control group(P<0.05).The total incidence of adverse reactions in the observation group was 10.00%,which was significantly lower than 33.33%in the control group(P<0.05).Conclusion Dex can better maintain the hemodynamic stability of patients undergoing brain tumor resection,and has better brain protection effect and medication safety.The mechanism may be related to the inhibition of oxidative stress response in the body.

关 键 词：脑肿瘤切除术 右美托咪定 脑保护效应 氧化应激 

分 类 号：R739.41[医药卫生—肿瘤]