右美托咪定对急性高血压脑出血术中麻醉效果和对大脑保护的影响  

Effect of Dexmedetomidine on Intraoperative Anesthesia Effect and Brain Protection on Acute Hypertensive Intracerebral Hemorrhage

作　　者：巫宇丛 梁荣耀 杨明明 仲绍华 冼炯斌 廖浪 WU Yucong;LIANG Rongrong;YANG Mingming;ZHONG Shaohua;XIAN Jiongbin;LIAO Lang(Guangdong Sanjiu Brain Hospital Department of Anesthesiology,Guangzhou 510510,China)

机构地区：[1]广东三九脑科医院麻醉科,广东广州510510

出　　处：《中华灾害救援医学》2024年第8期953-956,共4页Chinese Journal of Disaster Medicine

摘　　要：目的分析在急性高血压脑出血患者术中采取右美托咪定联合瑞芬太尼的麻醉效果。方法选取2022年2月至2024年2月于广东三九脑科医院就诊的92例需手术治疗的急性高血压脑出血患者,分为观察组(右美托咪定+瑞芬太尼治疗方案,n=46)与对照组(丙泊酚+瑞芬太尼治疗方案,n=46)。比较不同时间点血气指标、镇静程度、S100β水平、围手术期不良反应情况。结果两组患者PaCO_(2)、PaO_(2)及pH水平在不同时间点T1~T5均无显著差异(P>0.05)。两组患者镇静程度Ramsay评分在T1时无显著差异(P=0.187),其余时间点T2~T5观察组Ramsay评分均显著高于对照组(P<0.05)。观察组患者中枢神经特异性蛋白S100β在术后6h、术后12h、术后24h均显著高于对照组(P<0.001)。围手术期,观察组麻醉不良反应总发生率为10.87%(5/46),显著低于对照组的23.91%[(13/46),P=0.036]。结论在急性高血压脑出血患者手术中采取右美托咪定麻醉不影响患者血气指标,镇静镇痛效应显著,有利于保护脑组织,且围手术期不良反应少。Objective To analyze the anesthetic effect of dexmedetomidine combined with remifentanyl in patients with acute hypertensive intracerebral hemorrhage.Methods A total of 92 patients who came to Guangdong Sanjiu Brain Hospital for treatment of acute hypertensive intracerebral hemorrhage from February 2022 to February 2024 were enrolled,and they were divided into observation group(dexmedetomidine+remifentanil,n=46)and control group(propofol+remifentanil,n=46).Blood gas indexes and sedation degree were compared at different time points.S100βlevel,perioperative adverse reactions.Results There was no significant difference in blood gas analysis of PaCO_(2),PaO_(2)and pH levels between the two groups at different time points(P>0.05).There was no significant difference in the Ramsay score of sedation between the two groups at T1(P=0.187),and the Ramsay score of the observation group in T2~T5 was significantly higher than that in the control group at other time points(P<0.05).The central nervous system-specific protein S100βin the observation group was significantly higher than that in the control group at 6 h,12 h and 24 h at different time points(P<0.001).In the perioperative period,the total incidence of adverse reactions to anesthesia in the observation group was 10.87%(5/46),which was significantly lower than that in the control group 23.91%[(13/46),P=0.036].Conclusions In patients with acute hypertensive intracerebral hemorrhage,dexmedetomidine anesthesia does not affect the blood gas indexes,and the sedative and analgesic effect is significant,which is conducive to the protection of brain tissue,and there are few perioperative adverse reactions.

关 键 词：高血压脑出血 右美托咪定 瑞芬太尼 

分 类 号：R614[医药卫生—麻醉学]