术后右美托咪定泵注对体外循环下冠状动脉旁路移植术患者心肺功能及谵妄的影响  

Effect of Post-operative Injection of Dexmedetomidine on Cardiopulmonary Function and Delusion in Patients Undergoing Coronary Artery Bypass Grafting Under Cardiopulmonary Bypass

作　　者：张倩 李瑞冰 郭立新 ZHANG Qian;LI Ruibing;GUO Lixin(Xingtai Central Hospital,Xingtai,Hebei,China 054000)

机构地区：[1]河北省邢台市中心医院,河北邢台054000

出　　处：《中国药业》2025年第6期99-102,共4页China Pharmaceuticals

基　　金：河北省邢台市科技计划项目[2019ZC202]。

摘　　要：目的探讨术后右美托咪定系统对体外循环下冠状动脉旁路移植术(CABG)患者的心肺功能及谵妄的影响。方法选取医院2017年8月至2020年8月收治的行CABG术的患者300例,按随机数字表法分为观察组和对照组,各150例。两组患者均予统一的麻醉诱导及支持方案,且术后进行心脏常规治疗。观察组患者予右美托咪定注射液0.2~0.7μg/(kg·h)维持静脉泵入,对照组患者予丙泊酚乳状注射液1.5~3.0 mg/(kg·h)持续静脉泵入。对比分析两组术后住院情况及并发症发生情况。结果观察组患者术后24 h的乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、心肌肌钙蛋白I水平均显著低于对照组(P<0.05);肺动态顺应性、肺总量、氧合指数均显著高于对照组,呼吸功显著小于对照组(P<0.05)。观察组患者术后谵妄发生率为6.00%,显著低于对照组的18.00%(P<0.05),且术后总引流量及住院时间较对照组更小、更短(P<0.05)。两组患者术后低血压、高血压及心动过缓等并发症发生率,以及重症监护室(ICU)停留时间、拔管时间、机械通气时间比较无显著差异(P>0.05)。结论右美托咪定用于CABG术后,对患者心脏及肺部功能有保护作用,并能减少术后谵妄的发生。Objective To explore the effects of postoperative dexmedetomidine administration on the cardiopulmonary function and delirium in patients undergoing coronary artery bypass grafting(CABG)under cardiopulmonary bypass.Methods A total of 300 patients who underwent CABG surgery in the hospital from August 2017 to August 2020 were selected and divided into an observation group and a control group according to the random number table method,with 150 patients in each group.Both groups received a standardized anesthesia induction and support protocol,and received routine cardiac treatment after surgery.The observation group was given dexmedetomidine injection at a maintenance rate of 0.2-0.7μg/(kg·h)via continuous intravenous infusion pump,while the control group was given propofol emulsion injection at a continuous rate of 1.5-3.0 mg/(kg·h)via intravenous infusion pump.The postoperative hospitalization status and the incidence of complications were compared and analyzed between the two groups.Results The levels of lactate dehydrogenase,creatine kinase,creatine kinase isoenzyme,and cardiac troponin I in the observation group at 24 hours after surgery were significantly lower than those in the control group(P<0.05).The dynamic pulmonary compliance,total lung capacity,and oxygenation index were significantly higher than those in the control group,and the work of breathing was significantly lower than that in the control group(P<0.05).The incidence of postoperative delirium in the observation group was 6.00%,which was significantly lower than 18.00%in the control group(P<0.05),and the total postoperative drainage volume and hospital stay were less and shorter than those in the control group(P<0.05).There were no significant differences in the incidence of complications such as postoperative hypotension,hypertension,and bradycardia between the two groups,nor in the length of stay in the intensive care unit(ICU),extubation time,and mechanical ventilation time(P>0.05).Conclusion Dexmedetomidine used after CABG surgery exhibi

关 键 词：右美托咪定 体外循环 冠状动脉旁路移植术 心肺功能 术后谵妄 

分 类 号：R969.4[医药卫生—药理学]