右美托咪定持续输注对不停跳冠脉搭桥术患者的麻醉效果分析  

Analysis of anesthesia effect of continuous infusion of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting

作　　者：王磊 杨宁 WANG Lei;YANG Ning(Department of Anesthesiology,Dongying Second People's Hospital,Dongying 257000,China)

机构地区：[1]东营市第二人民医院麻醉科,257000

出　　处：《中国现代药物应用》2025年第7期6-10,共5页Chinese Journal of Modern Drug Application

摘　　要：目的分析不停跳冠状动脉(冠脉)搭桥术患者麻醉中应用右美托咪定持续输注的有效性。方法选择66例不停跳冠脉搭桥术患者,根据随机数字表法分为对照组和观察组,每组33例。对照组提供常规全身麻醉,观察组在常规全身麻醉基础上提供右美托咪定持续输注。比较两组不同时间点的心率、平均动脉压、心肌肌钙蛋白I、肌酸激酶同工酶。结果观察组切皮时(T3)、劈胸(T4)、搭桥前(T5)、搭桥时(T6)、手术结束时(T7)的心率低于对照组,差异有统计学意义(P<0.05)。观察组切皮前(T2)、T3、T4、T5、T6、T7的平均动脉压均低于对照组,差异有统计学意义(P<0.05)。观察组心肌肌钙蛋白I在手术结束即刻(4.26±0.74)μg/L、术后第3天(1.16±0.28)μg/L、术后第5天(0.51±0.08)μg/L均低于对照组的(5.78±0.72)、(1.72±0.28)、(0.75±0.12)μg/L,差异有统计学意义(P<0.05)。观察组肌酸激酶同工酶在手术结束即刻(22.17±3.27)U/L、术后第3天(15.65±2.17)U/L、术后第5天(8.23±1.21)U/L均低于对照组的(28.49±3.21)、(19.32±1.78)、(9.38±1.21)U/L,差异有统计学意义(P<0.05)。结论不停跳冠脉搭桥术患者全身麻醉过程中应用右美托咪定持续输注可以维持机体术中血流动力学指标稳定,并且保护心肌细胞,降低心肌缺血再灌注(I/R)损伤,有较高的应用价值。Objective To analyze the effectiveness of continuous infusion of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting.Methods A total of 66 patients with off-pump coronary artery bypass grafting were selected and divided into a control group and an observation group according to random number table method,with 33 cases in each group.The control group was provided with routine general anesthesia,while the observation group was provided with continuous infusion of dexmedetomidine on the basis of routine general anesthesia.The heart rate,mean arterial pressure,myocardial troponin I and creatine kinase isoenzyme of the two groups were compared.Results The heart rates of the observation group during skin resection(T3),chest division(T4),before bypass(T5),at bypass(T6)and at the end of operation(T7)were lower than that of the control group,and the difference was statistically significant(P<0.05).The mean arterial pressure before skin resection(T2),T3,T4,T5,T6 and T7 in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The myocardial troponin I in the observation group was(4.26±0.74)μg/L immediately after surgery,(1.16±0.28)μg/L on the 3rd day after surgery,and(0.51±0.08)μg/L on the 5th day after surgery,which were lower than(5.78±0.72),(1.72±0.28)and(0.75±0.12)μg/L in the control group,and the difference was statistically significant(P<0.05).The creatine kinase isozyme in the observation group was(22.17±3.27)U/L immediately after surgery,(15.65±2.17)U/L on the 3rd day after surgery,and(8.23±1.21)U/L on the 5th day after surgery,which were lower than(28.49±3.21),(19.32±1.78),and(9.38±1.21)U/L in the control group,and the difference was statistically significant(P<0.05).Conclusion Continuous infusion of dexmedetomidine during anesthesia in patients undergoing off-pump coronary artery bypass grafting can maintain stable hemodynamic parameters during surgery,protect myocardial cells,reduce ischemia-reperfusion

关 键 词：不停跳冠状动脉搭桥术 右美托咪定 持续输注 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]