| 摘要: |
| ［摘要］ 目的 探讨右美托咪定注射液对Stanford A型主动脉夹层行全脉弓人工血管置换术后谵妄发生的影响。方法 选取2015-06～2017-06该院收治的Stanford A型主动脉夹层且行全脉弓人工血管置换术患者117例，采用随机数字表法将其分为右美托咪定组（n=59）和丙泊酚组（n=58）。两组患者采用相同的麻醉和手术方法，入重症监护室（ICU）后，右美托咪定组采用右美托咪定0.40～0.80 μg/（kg·h）静脉泵入，至患者拔管前30 min停用；丙泊酚组则给予丙泊酚25～40 μg/（kg·min）泵入，于拔管前2 h停用。比较两组术中术后指标、术后不良反应发生率和术后谵妄发生率。结果 右美托咪定组患者机械通气时间、停药后唤醒时间、ICU停留时间和总住院时间均短于丙泊酚组，差异有统计学意义（P<0.05）。两组在低血压、心动过缓及恶心/呕吐发生率方面比较差异均无统计学意义（P>0.05）。与丙泊酚组比较，右美托咪定组谵妄发生率更低，谵妄始发时间更迟，且谵妄持续时间较短，差异有统计学意义（P<0.05）。结论 右美托咪定相比于丙泊酚，可减少Stanford A型主动脉夹层行全脉弓人工血管置换术后机械通气时间和ICU停留时间，降低谵妄发生率，缩短患者总住院时间。 |
| 关键词: Stanford A型主动脉夹层 全脉弓人工血管置换术 右美托咪定 丙泊酚 谵妄 |
| DOI：10.3969/j.issn.1674-3806.2020.07.06 |
| 分类号:R 614 |
| 基金项目:河南省医学科技攻关计划项目（编号：2018020562） |
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| Effect of dexmedetomidine injection on postoperative delirium in patients with Stanford type A aortic dissection undergoing total arch replacement surgery |
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CAO Bao-jiang, YE Fa-min, ZHANG Jing-jing, et al.
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Coronary Heart Disease Intensive Care Unit, Fuwai Central China Cardiovascular Hospital, Henan Provincial People′s Hospital, Zhengzhou 450003, China
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| Abstract: |
| ［Abstract］ Objective To investigate the effect of dexmedetomidine injection on postoperative delirium in patients with Stanford type A aortic dissection undergoing total arch replacement surgery. Methods A total of 117 patients with Stanford type A aortic dissection undergoing total arch replacement surgery from June 2015 to June 2017 in our hospital were selected. The patients were randomly divided into the dexmedetomidine group(n=59) and the propofol group(n=58) by random number table method. Both groups underwent the same anesthesia and surgery. After admission to the Intensive Care Unit(ICU), the dexmedetomidine group was intravenously pumped with dexmedetomidine 0.40～0.80 μg/(kg·h) until 30 minutes before extubation, while the propofol group was intravenously pumped with propofol 25～40 μg/(kg·min) until 2 hours before extubation. The intraoperative and postoperative indexes, the incidence of postoperative adverse reactions and the incidence of postoperative delirium were compared between the two groups. Results The patients in the dexmedetomidine group had shorter mechanical ventilation time, wake-up time after drug withdrawal, ICU stay time and total hospital stay time than those in the propofol group, and the difference was statistically significant(P<0.05). There were no significant differences in the incidence rates of hypotension, bradycardia, and nausea/vomiting between the two groups(P>0.05). Compared with the propofol group, the dexmedetomidine group had lower incidence of delirium, later onset of delirium and shorter duration of delirium, with statistically significant differences between the two groups(P<0.05). Conclusion Compared with propofol, dexmedetomidine can reduce mechanical ventilation time and ICU stay time in the patients with Stanford type A aortic dissection after total arch replacement surgery, reduce the incidence of delirium and shorten the total hospital stay. |
| Key words: Stanford type A aortic dissection Total arch replacement surgery Dexmedetomidine Propofol Delirium |
