右美托咪定复合丙泊酚对颅脑损伤患者肝肾功能血气分析的影响

Effects of Dexmedetomidine Combined with Propofol on Liver and Kidney Function and Blood Gas Analysis in Patients with Brain Injury

目的:研究右美托咪定复合丙泊酚对颅脑损伤患者肝肾功能、血气分析的影响。方法:选取2012年11月至2017年11月收治于我院颅脑损伤患者80例(肝肾功能正常40例、肝肾功能异常40例)进行回顾性研究。按照随机数表法将40例肝肾功能正常患者均分为A组、B组各20例,将40例肝肾功能异常患者均分为C组、D组各20例。A组、C组使用右美托咪定复合丙泊酚诱导麻醉,B组、D组单独使用丙泊酚进行诱导麻醉。统计所有患者的一般资料(性别、年龄、BMI、ASA评分及手术时间),患者手术前(T1)、手术后12h(T2)、手术后24h(T3)的肝功能(AST、ALT)、肾功能(血肌酐、血尿素氮)、血气分析(Pa O2、Pa CO2)检查结果。结果:手术后12h、手术后24h各组患者AST及ALT无明显变化(P>0.05),A组与B组、C组与D组在同时间点AST、ALT差异不明显(P>0.05)。手术后12h、手术后24h各组患者BUN及Scr均明显升高(P<0.05)。术后同时间点对比,患者血尿素氮及血肌酐水平A组明显低于B组(P<0.05),C组明显低于D组(P<0.05)。术后各组患者Pa O2均有明显降低(P<0.05)、Pa CO2均具有明显升高(P<0.05)。术后同时间点患者Pa O2值A组高于B组(P<0.05)、C组明显高于D组(P<0.05),Pa CO2值A组明显低于B组(P<0.05)、C组明显低于D组(P<0.05)。结论:右美托咪定复合丙泊酚能改善颅脑损伤患者术后肾脏功能和血气分析结果,但对肝脏无明显保护作用,对肝功能影响小。

Objective： To study the effects of dexmedetomidine and propofol in patients with liver and kidney function,blood gas analysis of craniocerebral injury. Methods： 80 cases of craniocerebral injury admitted in our hospital from November 2012 to November 2017（ 40 cases of normal liver and kidney function,40 cases of abnormal liver and kidney function） were retrospectively studied. According to the random number table method,40 cases of patients with normal liver function were divided into group A and group B,each of 20 cases; 40 cases of liver and kidney dysfunction were divided into group C and group D,each of 20 cases.Group A and group C were anesthetized with dexmedetomidine combined with propofol,and group B and D were used to induce anesthesia by propofol alone. The general data of all patients（ gender,age,BMI,ASA score,and operation time） were counted; The liver function（ AST,ALT）,renal function（ serum creatinine,blood urea nitrogen） and blood gas analysis（ Pa O2 and Pa CO2） were detected before operation（ T1）,12 h（ T2） after operation and 24 h（ T3） after operation. Results： There was no significant changes of AST and ALT in 12 h and 24 h after operation（ P〈0. 05）. There was no significant difference in AST and ALT between group A and group B,group C and group D at the same time point（ P〈0.05）. 12 h and 24 h after operation,the BUN and Scr were significantly increased（ P〈0.05）. The blood urea nitrogen and serum creatinine levels in the group A were significantly lower than those in the group B（ P〈0.05）,and the group C was significantly lower than that in the group D（ P〈0.05）. After operation,all the patients in each group decreased significantly（ P〈0.05） and Pa CO2 significantly increased（ P〈0.05）. At the same time point,the Pa O2 value of group A was higher than that of group B（ P〈0. 05）,and the C group was significantly higher than that of group D（ P〈0.05）,Pa CO2 value in group A was significantly lower than that of group B（ P〈0.05）. Conclusion： Dexmedetomidine combined with propofol can improve renal function and blood gas analysis in patients with craniocerebral injury,but has no obvious protective effect on liver and little effect on liver function.