右美托咪定静脉麻醉在急性前循环闭塞性卒中血管内治疗中的疗效及安全性  

Efficacy and Safety of Dexmedetomidine in Intravenous Anesthesia for Endovascular Treatment of Acute Anterior Circulation Ischemic Stroke

作　　者：陈良义[1] 陈星宇[1] 张建平 翁磊华 CHEN Liangyi;CHRN Xingyu;ZHANG Jianping;WENG Leihua(Department of Neurology,Zhongshan Hospital Affiliated to Xiamen University,Fujian Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院神经内科,福建厦门361004

出　　处：《神经损伤与功能重建》2023年第11期626-629,共4页Neural Injury and Functional Reconstruction

基　　金：福建省自然科学基金(No.2020J05290)。

摘　　要：目的:探索右美托咪定静脉麻醉在急性前循环闭塞性卒中血管内治疗(EVT)中应用的疗效。方法:选择2019年6月至2021年6月厦门大学附属中山医院诊治的行EVT治疗的急性前循环闭塞性卒中患者116例,采用随机数字表法分为局部麻醉组(对照组)和局部麻醉联合术中右美托咪定静脉麻醉组(观察组)。比较2组患者疗效、并发症、S100-β及美国国立卫生院脑卒中量表(NIHSS)评分差异。结果:观察组血压波动发生率、穿刺到血管再通时间(PRT)、受线时间及取栓次数低于对照组(P<0.05),首次再通率高于对照组(P<0.05)。2组的血氧饱和度(SpO2)、肺部感染率、死亡率、总再通率及症状性颅内出血(SICH)的发生率差异无统计学意义(P>0.05)。2组术前及术后7 d的NIHSS评分均无统计学差异(P>0.05),但观察组术后7 d时NIHSS评分下降≥8分的患者比例显著高于对照组(P<0.05);2组术前S100-β水平差异无统计学差异(P>0.05),术后3d,观察组的S100-β水平低于对照组(P<0.05)。结论:右美托咪定应用于急性前循环闭塞性卒中EVT可提高疗效及降低神经功能损伤,具有高效安全等优点。Objective:To explore the efficacy of dexmedetomidine in intravenous anesthesia for endovascular treatment(EVT)of acute anterior circulation ischemic stroke.Methods:A total of 116 patients with acute anterior circulation ischemic stroke treated by EVT in Zhongshan Hospital affiliated to Xiamen University from June 2019 to June 2021 were selected as the research object.The patients were randomly divided into the local anesthesia group(control group)and the local anesthesia combined with intravenous anesthesia of dexmedetomidine injection during operation group(observation group)by using random number table method.The efficacy,complications,S100-βand NIHSS scores were compared between the two groups.Results:The incidence of blood pressure fluctuation,puncture to recanalization time(PRT),radiation exposure time,and thrombectomy times in the observation group were significantly lower than those in the control group(all P<0.05),and the first recanalization rate was higher than that in the control group(P<0.05).There was no significant difference in SpO2,pulmonary infection,mortality,total recanalization rate and incidence of SICH between the two groups(P>0.05).There was no significant difference in NIHSS score between the two groups before and after surgery(P>0.05),but the proportion of patients with a decrease of NIHSS score≥8 points in observation group was significantly higher than that in control group(P<0.05).There was no significant difference in S100-βlevel between the two groups before surgery(P>0.05),but S100-βlevel in observation group was lower than that in control group at 7 days after surgery(P<0.05).Conclusion:The application of dexmedetomidine in EVT for acute anterior circulation ischemic stroke can improve the curative effect and reduce nerve function damage,which has the advantages of high efficiency and safety.

关 键 词：右美托咪定 急性前循环闭塞性卒中 血管内治疗 S100-Β蛋白 疗效 安全性 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学] R743