右美托咪定与七氟醚复合麻醉对老年脑肿瘤切除术患者脑保护的影响

Effect of dexmedetomidine and sevoflurane combined anesthesia on brain protection in elderly patients with brain tumor resection

目的探讨右美托咪啶与七氟醚复合麻醉对老年脑肿瘤切除后的脑保护作用及机制,为临床上合理使用右美托咪定与七氟醚复合麻醉提供指导依据。方法选择60例施行脑肿瘤切除手术的老年患者,分为实验组和对照组,每组30例。实验组应用右美托咪定与七氟醚复合麻醉,对照组应用七氟醚麻醉,两组分别在麻醉前(T1)、切除肿瘤时(T2)、手术结束时(T3)以及术后12 h(T4)时间点静脉取血,检测血液样品中NSE、S100β和肾上腺素浓度。结果经过对两组不同时间点NSE、S100β和肾上腺素浓度的比较发现,实验组的NSE、S100β和肾上腺素浓度T2~T4显著低于对照组(P<0.05)。结论右美托咪定与七氟醚复合麻醉的脑保护作用优于七氟醚麻醉效果,其可能是通过降低血液中的儿茶酚胺类激素含量来实现脑保护作用。

Objective To investigate the mechanism of the protective effect of dexmedetomidine and sevoflurane combined anesthesia on brain protection in elderly brain tumor after resection, and to provide guidance basis for the rational use of dexmedetomidine combined with sevoflurane clinically. Methods A total of 60 elderly patients who underwent brain tumor resection were divided into experimental group and control group, with 30 cases in each group. The experimental group was treated with intravenous administration of dexmedetomidine before surgery. The venous blood of the two groups was taken before surgery（T1）, at the time of tumor resection（T2）, at the end of operation（T3） and at 12 h after surgery（T4）. And the levels of NSE, S100β and adrenaline in blood samples were measured. Results By comparing the concentrations of NSE, S100β and adrenaline of the two groups at two different time points, the NSE, S100β and adrenaline concentrations in the experimental group in T2~T4 were significantly lower than those in the control group（P〈0.05）. Conclusion The protective effect of dexmedetomidine-sevoflurane combined anesthesia is superior to that of sevoflurane anesthesia and may be achieved by reducing the content of catecholamine in the blood.