右美托咪啶复合麻醉对硬膜外血肿清除术患者脑保护效应

Cerebral Protection Clinical Effect Observation of Dexmedetomidine Combined Anesthesia for Epidural Hematoma Clearing Patients

目的:观察右美托咪啶复合麻醉对颅内硬膜外血肿清除术对患者的脑保护效应。方法:硬膜外血肿手术患者60例随机分成两组,分别给予丙泊酚复合麻醉和右美托咪啶复合麻醉,比较两组患者手术前后的神经功能、血清学指标及药品不良反应发生情况。结果:观察组患者术后24 h格拉斯哥昏迷评分(GCS评分)明显高于对照组(P<0.05),术后24 h的血清神经元特异性烯醇化酶(NSE)和内皮素(ET)水平均明显低于对照组(P<0.05);观察组患者药品不良反应发生率明显低于对照组(P<0.05)。结论:硬膜外血肿清除术患者采用右美托咪定复合麻醉,术后GCS评分与血清NSE、ET水平均明显优于采用丙泊酚复合麻醉的患者,且不良反应明显较少,提示右美托咪定复合麻醉对患者的脑保护效应更佳,且安全性高。

Objective： To observe the cerebral protection of dexmedetomidine combined anesthesia for epidural he- matoma clearing patients. Methods：60 cases patients with epidural hematoma operation were divided into two groups ran- domly. They were given anesthesia before surgery isopropyl propofol compound anesthesia and dexmedetomidine combined anesthesia respectively. The nerve function and serological indexes before and after surgery and the adverse drug reactions of the two groups were compared. Results：The postoperative 24h Glasgow coma scale （GCS） of the observation group was significantly higher than the control group（ P 〈 0.05 ）. The postoperative 24h serum levels of NSE and endothelin of obser- vation group was significantly lower than the control group （P 〈 0.05 ）. The incidence of adverse reactions such as reflux aspiration, restlessness, nausea vomiting, bronchospasm of observation group was significantly lower than the control group （ P 〈 0.05 ）. Conclusion： The postoperative GCS score and serum NSE, ET levels of the epidural hematoma clearing pa- tients with dexmedetomidine combined anesthesia were significantly much better than the patients with propofol combined anesthesia. It revealed that dexmedetomidine combined anesthesia had better cerebral protective effect.