脑幕上肿瘤切除术患者采用右美托咪定对其微循环及乳酸的影响

Impact of dexmedetomidine on microcirculation and lactic acid in supratentorial tumor resection

目的探讨右美托咪定对脑幕上肿瘤切除术患者微循环及乳酸的影响。方法选取48例行脑幕上肿瘤切除术患者作为研究对象,随机分为试验组和对照组,2组患者均为24例。试验组患者在麻醉过程中给予0.4μg/(kg·h)右美托咪定注射液,对照组患者给予相同剂量的0.9%Na Cl注射液。观察2组患者麻醉诱导前(t0)、气管插管时(t1)、分离肿瘤时(t2)、切除肿瘤时(t3)和缝硬脑膜时(t4)的脑乳酸生成率、动脉压、心率和呼吸频率。结果试验组患者t1、t2、t3和t4时间点血乳酸生成量、脑乳酸生成率均显著低于对照组(P<0.05)。试验组患者t1、t2、t3和t4时间点平均动脉压、心率均显著低于对照组,呼吸频率高于对照组(P<0.05)。结论右美托咪定应用于脑幕上肿瘤切除术患者,可显著降低患者脑乳酸的生成,有效维持患者术中的血压、心率和呼吸频率,改善微循环。

Objective To evaluate the effects of dexmedetomidine on microcirculation and lactic acid during supratentorial tumor resection.Methods A total of 48 patients with supratentorial tumor resection were randomly divided into control group and experimental group. Each group included24 patients. The experiemental group were given 0. 4 μg/（kg·h） dexmedetomidine during the anesthesia but the control group were given the same dose of 0. 9% Na Cl injection. The cerebral lactic acid production rate,arterial pressure,heart rate and respiratory rate before induction of anesthesia（t0）,intubation（t1）,separating tumor（t2）,excising tumor（t3） and sewing duramater（t4） were compared between 2 groups. Results The blood lactic acid generation,brain lactic acid formation rate of experimental group were significantly lower than the control group at t1,t2,t3 and t4. At t1,t2,t3 and t4,the mean arterial pressure,heart rate of experimental group were significantly lower than the control group,the breathing rate was higher than the control group（P 〈0. 05）. Conclusion Dexmedetomidine application in the supratentorial tumor resection can significantly reduce the cerebral lactic acid production rate,keep the arterial pressure,heart rate and respiratory rate and improve the microcirculation.