引用本文:陈伟涛,陈志毅,黄浩铭.右美托咪定预处理在颅内动脉瘤夹闭术中的临床应用效果观察[J].中国临床新医学,2022,15(4):352-355.
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右美托咪定预处理在颅内动脉瘤夹闭术中的临床应用效果观察
陈伟涛,陈志毅,黄浩铭
528400 广东,中山市中医院麻醉科
摘要:
[摘要] 目的 观察右美托咪定预处理在颅内动脉瘤夹闭术中的临床应用效果。方法 选择2019年6月至2021年5月中山市中医院收治的颅内动脉瘤患者80例,均行全身麻醉气管插管下开放动脉瘤夹闭术。采用随机数字表法将其分为观察组和对照组,每组40例。观察组在麻醉诱导气管插管前静脉泵注右美托咪定,对照组使用等量生理盐水进行处理。比较两组手术结束时脑氧代谢指标水平。比较两组术中丙泊酚、瑞芬太尼和七氟醚用量,以及拔管前循环功能相关指标水平。结果 在手术结束时,观察组颅内压低于对照组,脑灌注压和脑氧摄取率均高于对照组,差异有统计学意义(P<0.05)。观察组术中丙泊酚、瑞芬太尼和七氟醚用量均显著少于对照组(P<0.05)。观察组拔管前心率慢于对照组,收缩压和舒张压均低于对照组,差异有统计学意义(P<0.05)。结论 颅内动脉瘤夹闭术行右美托咪定预处理可改善脑灌注,减少麻醉药物用量,有利于维持患者术中生命体征平稳,提高手术安全性。
关键词:  右美托咪定  预处理  颅内动脉瘤  夹闭术  脑氧代谢
DOI:10.3969/j.issn.1674-3806.2022.04.15
分类号:R 614
基金项目:
Observation on the clinical application effect of pretreatment with dexmedetomidine on intracranial aneurysm clipping
CHEN Wei-tao, CHEN Zhi-yi, HUANG Hao-ming
Department of Anesthesiology, Zhongshan Traditional Chinese Medicine Hospital, Guangdong 528400, China
Abstract:
[Abstract] Objective To observe the clinical application effect of pretreatment with dexmedetomidine on intracranial aneurysm clipping. Methods Eighty patients with intracranial aneurysm admitted to Zhongshan Traditional Chinese Medicine Hospital from June 2019 to May 2021 were selected, and all the patients underwent open aneurysm clipping under general anesthesia and endotracheal intubation. The patients were divided into observation group and control group by random number table method, with 40 cases in each group. The observation group was treated with dexmedetomidine by intravenous pump before anesthesia induction and tracheal intubation, and the control group was treated with the same amount of normal saline. The levels of cerebral oxygen metabolism indexes at the end of surgery were compared between the two groups. The intraoperative doses of propofol, remifentanil and sevoflurane, and the levels of circulatory function-related indicators before extubation were compared between the two groups. Results At the end of the operation, the intracranial pressure in the observation group was lower than that in the control group, and the cerebral perfusion pressure and cerebral oxygen uptake rate in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). The intraoperative doses of propofol, remifentanil and sevoflurane in the observation group were significantly lower than those in the control group(P<0.05). Before extubation, the heart rate in the observation group was slower than that in the control group, and the systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion Pretreatment with dexmedetomidine in intracranial aneurysm clipping can improve cerebral perfusion, reduce the dosage of anesthetics, and help to maintain the stability of the patients′ vital signs during surgery and improve surgical safety.
Key words:  Dexmedetomidine  Pretreatment  Intracranial aneurysm  Clipping  Cerebral oxygen metabolism