右美托咪定、异丙酚复合麻醉对脑肿瘤切除手术患者的脑保护效果比较  

Comparison of Brain Protection Effects of Dexmedetomidine and Propofol Combined Anesthesia on Patients Undergoing Brain Tumor Resection Surgery

作　　者：张磊 ZHANG Lei(Department of Anesthesiology,Tianjin Beichen District Hospital of Traditional Chinese Medicine,Tianjin 300499,China)

机构地区：[1]天津市北辰区中医医院麻醉科,天津300499

出　　处：《医学信息》2023年第24期106-109,共4页Journal of Medical Information

摘　　要：目的对比右美托咪定(Dex)、异丙酚(Pro)复合麻醉对脑肿瘤切除手术患者的脑保护效果。方法选取2017年3月-2022年10月于我院行脑肿瘤切除手术的86例患者为研究对象,按照随机数字表法分为Dex组(43例)和Pro组(43例),Dex组采用右美托咪定复合麻醉,Pro组则应用异丙酚复合麻醉,比较两组麻醉诱导前(T0)、麻醉诱导后即刻(T1)、硬脑膜切开时(T2)、手术结束即刻(T3)、术后6 h(T4)的血流动力学指标[平均动脉压(MAP)、心率],同时监测患者T0、T3、术后24 h(T5)、术后3 d(T6)的脑损伤指标[神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S-100β)],并统计其麻醉起效时间、苏醒时间、气管拔管时间及两组麻醉不良反应。结果相较于T0,两组T1、T2、T3时HR、MAP指标均有升高(P<0.05);但Dex组T1、T2、T3时HR、MAP水平低于Pro组(P<0.05);相较于T0,两组T3、T5时NSE、S-100β指标均有升高(P<0.05),但Dex组T3、T5时NSE、S-100β水平低于Pro组(P<0.05)。Dex组麻醉起效时间、苏醒时间、气管拔管时间均短于Pro组(P<0.05);Dex组麻醉不良反应发生率小于Pro组(P<0.05)。结论Dex复合麻醉可降低脑肿瘤切除手术患者的血流动力学波动,减少脑组织损伤,其脑保护效果优于Pro复合麻醉,且麻醉起效更快、苏醒时间更短。Objective To compare the brain protective effects of dexmedetomidine(Dex)and propofol(Pro)combined anesthesia in patients undergoing brain tumor resection.Methods A total of 86 patients who underwent brain tumor resection in our hospital from March 2017 to October 2022 were selected as the research objects.According to the random number table method,they were divided into Dex group(43 patients)and Pro group(43 patients).Dex group was treated with dexmedetomidine combined anesthesia,and Pro group was treated with propofol combined anesthesia.The hemodynamic indexes[mean arterial pressure(MAP),heart rate]of the two groups before anesthesia induction(T0),immediately after anesthesia induction(T1),dural incision(T2),immediately after operation(T3)and 6 h after operation(T4)were compared.At the same time,the brain injury indexes[neuron-specific enolase(NSE),central nervous system specific protein(S-100β)]of patients at T0,T3,24 h after operation(T5)and 3 d after operation(T6)were monitored,and the onset time of anesthesia,recovery time,extubation time and adverse reactions of the two groups were counted.Results Compared with T0,the levels of HR and MAP at T1,T2 and T3 in the two groups were increased(P<0.05).However,the levels of HR and MAP at T1,T2 and T3 in Dex group were lower than those in Pro group(P<0.05).Compared with T0,the levels of NSE and S-100βat T3 and T5 in the two groups increased(P<0.05),but the levels of NSE and S-100βat T3 and T5 in the Dex group were lower than those in the Pro group(P<0.05).The onset time of anesthesia,recovery time and tracheal extubation time in the Dex group were shorter than those in the Pro group(P<0.05).The incidence of anesthesia adverse reactions in the Dex group was lower than that in the Pro group(P<0.05).Conclusion Dex combined anesthesia can reduce hemodynamic fluctuations and brain tissue damage in patients undergoing brain tumor resection.Meanwhile,its brain protection effect is better than that of Pro combined anesthesia,and the onset of anesthesia is faster and t

关 键 词：脑肿瘤切除手术 右美托咪定 异丙酚 脑保护 血流动力学 

分 类 号：R614[医药卫生—麻醉学]