右美托咪啶对非体外冠脉旁路移植术应激的影响

Affect dexmedetomidine on-pump coronary artery bypass grafting stress response

目的评价右美托咪啶（Dex）对患者非体外循环冠状动脉旁路移植术应激反应的影响。方法择期非体外循环冠状动脉旁路移植术患者40例,性别不限,ASA分级Ⅱ或Ⅲ级,年龄53～65岁,随机分为两组：对照组（N）组和右美托咪啶组（D）组。D组于气管插管后静脉泵注Dex,负荷量1μg/kg,时间为15min,继以0.3μg/（kg·h）输注至术毕,N组静脉输注等量的生理盐水。观察记录患者入室时（T0）、插管后30min（T1）、手术结束（T2）、手术后24h（T3）时的心率（HR）、平均动脉压（MAP）并于T0、T1、T2、T3抽取动脉血检测血糖浓度和乳酸含量。结果与T0时期相比,N组患者MAP、HR在T1、T2时明显增高,有显著性差异,血糖（Glu）、乳酸（Lac）在T1、T2、T3时有明显差异（P〈0.05）。结论右美托咪啶可明显降低非体外循环冠状动脉旁路移植术患者应激反应的影响和血糖、乳酸的浓度。

Objective To evaluate the effect of the dexmedetomidine（ DEX） in patients with coronary artery bypass grafting without cardiopulmonary stress response. Methods Elective off- pump coronary artery bypass grafting in patients with 40 cases,male or female,ASA grade Ⅱ or grade Ⅲ,aged 53 ～ 65 years old,were randomly divided into two groups： a control group（ N） group and right dexmedetomidine group（ D） group. Group D intravenous infusion of DEX,load 1 μg / kg,for 15 minutes after intubation,followed by 0. 3 μg /（ kg·h） infusion to surgery,N intravenous infusion of normal saline group. Observed were recorded burglary（ T0）,after intubation 30 min（ T1）,the end of surgery（ T2）,after heart surgery 24h（ T3） when（ HR）,mean arterial pressure（ MAP） and at T0,T1,T2,T3 extract arterial blood glucose concentration and lactic acid content. Results Compared with the period T0,N patients MAP,HR at T1,T2,while significantly higher,there are significant differences in blood glucose（ Glu）,lactate（ Lac） at T1,T2,there are significant differences（ P〈0. 05 T3 time）. Conclusion Dexmedetomidine can significantly reduce the off- pump coronary artery bypass grafting in patients with stress response and glucose,lactate concentration.