右美托咪定辅助麻醉对全髋关节置换术患者脑氧代谢、应激反应的影响分析  

Effects of Dexmedetomidine Assisted Anesthesia on Cerebral Oxygen Metabolism and Stress Response in Patients Undergoing Total Hip Arthroplasty

作　　者：樊志龙 汪海涛 顾静 FAN Zhilong;WANG Haitao;GU Jing(Department of Anesthesiology,Jiangyin Lingang Hospital,Jiangyin,Jiangsu,214443,China)

机构地区：[1]江阴临港医院麻醉科,江苏江阴214443

出　　处：《中外医疗》2024年第28期59-62,71,共5页China & Foreign Medical Treatment

摘　　要：目的探究右美托咪定应用于全髋关节置换术患者中对脑氧代谢、应激反应的影响。方法随机选取2021年1月—2023年12月江阴临港医院骨科收治的60例全髋关节置换术患者作为研究对象,依据不同麻醉方案分为研究组和参比组,每组30例。参比组给予常规全身麻醉,研究组在参比组基础上辅助采用右美托咪定。对比两组患者脑氧代谢指标水平、应激反应指标水平及不良反应发生率。结果麻醉时、手术开始时、手术开始30 min,研究组颈内静脉血氧含量(oxygen content in venous blood,CjvO^(2))为(90.24±5.97)mL/L、(83.62±5.20)mL/L、(81.37±5.17)mL/L,均低于参比组的(93.63±6.07)mL/L、(87.95±5.44)mL/L、(84.51±5.21)mL/L,动脉血氧含量(arterial oxygen content,CaO^(2))为(139.35±13.45)%、(133.15±12.14)%、(130.02±10.25)%,均低于参比组的(146.56±13.97)%、(140.22±12.07)%、(135.54±10.81)%,差异有统计学意义(t=2.181、3.151、2.343、2.197、2.262、2.030,P均<0.05)。两组患者术前和术后6 h时CjvO^(2)及CaO^(2)水平比较,差异无统计学意义(P均>0.05)。麻醉前,两组患者肾上腺素、皮质醇水平比较,差异无统计学意义(P均>0.05);研究组插管后、术后24 h肾上腺素、皮质醇水平均低于参比组,差异有统计学意义(P均<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论在全髋关节置换术患者的全身麻醉中辅助使用右美托咪定能够有效维持脑氧代谢、抑制应激反应,且不额外增加不良反应的发生。Objective To explore the effects of dexmedetomidine on cerebral oxygen metabolism and stress response in patients with total hip replacement.Methods A total of 60 patients with total hip arthroplasty admitted to the Department of Orthopedics of Jiangyin Lingang Hospital from January 2021 to December 2023 were randomly selected as the study objects and divided into study group and reference group according to different anesthesia protocols,with 30 cases in each group.The reference group was given general anesthesia,and the study group was supplemented with dexmedetomidine.The levels of cerebral oxygen metabolism indexes,stress response indexes and the incidence of adverse reactions were compared between the two groups.Results At during anesthesia,at the beginning of surgery,and 30 min after the beginning of surgery,the oxygen content of the jugular vein blood(CjvO^(2))in the study group were(90.24±5.97)mL/L,(83.62±5.20)mL/L,and(81.37±5.17)mL/L,respectively,which were lower than those of the reference group(93.63±6.07)mL/L,(87.95±5.44)mL/L,and(84.51±5.21)mL/L;the arterial oxygen content(CaO^(2))were(139.35±13.45)%,(133.15±12.14)%,and(130.02±10.25)%,respectively,which were lower than those of the reference group(146.56±13.97)%,(140.22±12.07)%,and(135.54±10.81)%,the differences were statistically significant(t=2.181,3.151,2.343,2.197,2.262,2.030,all P<0.05);there was no statistically significant difference in CjvO^(2) and CaO^(2) levels between the two groups at preoperative and postoperative 6 h(P>0.05).Before anesthesia,there was no statistically significant difference in adrenaline and cortisol levels between the two groups(both P>0.05);after intubation and within 2 hours after surgery,the adrenaline and cortisol levels in the study group were lower than those in the reference group,and the differences were statistically significant(both P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The adjuvant use of dexmedeto

关 键 词：右美托咪定 辅助麻醉 全髋关节置换术 脑氧代谢 应激反应 

分 类 号：R614[医药卫生—麻醉学]