摘要
目的观察不同靶控质量浓度右美托咪定对颅内动脉瘤患者脑氧代谢的影响。方法我院2013年6月~2017年1月收治的颅内动脉瘤患者120例,随机分为4组,A,B和C组分别于麻醉诱导前20min,靶控输注右美托咪定3,5和7ng·mL^(-1),D组作为对照组,泵注等量生理盐水。4组均于术中行脑电双频指数监测,比较4组平均动脉压(MAP)及心率(HR)的变化,并于不同时刻抽取患者颈内静脉球部血及桡动脉血行血气分析,计算动脉-颈内静脉球部血氧差[D_((a-jv)O_2)]及脑氧摄取率(CEO_2)进行统计学分析。结果 A,B和C 3组靶控输注右美托嘧啶后MAP及HR均降低,且C组降低幅度高于A和B组(P<0.05);A,B和C 3组D_((a-jv)O_2)及CEO_2低于D组,且C组D_((a-jv)O_2)及CEO_2低于A和B组(P<0.05)。结论右美托咪定可降低D_((a-jv)O_2)及CEO_2,且一定范围内随着靶控质量浓度的增加,其D_((a-jv)O_2)及CEO_2随之降低。
Objective To observe the effects of different target controlled concentration dexmedetomidine on cerebral oxygen metabolism in patients with intracranial aneurysms.Methods 120 cases in our hospital from June 2013 to January 2017 with intracranial aneurysm were randomly divided into 4 groups.Group A,B and C were given the target controlled infusion 3,5 and 7 ng·mL^-1 respectively before the anesthesia induction in 20 min.The group D used as the control group were given the same amount of normal saline injection pump.All 4 groups took monitoring of bispectral index,then to compare four groups′mean arterial pressure(MAP)and heart rate(HR)change,and take arterial blood gas analysis by extract blood and radial artery of the internal jugular vein at different times for arterial-internal jugular venous hemorrhage[D((a-jv)O2)].And cerebral oxygen uptake rate(CEO2)for statistical analysis.The mean arterial pressure(MAP),heart rate(HR)and blood gas were determined.Results In the group A,B and C,the dexmedetomidine reduced MAP and HR,and the reduction of group C were more obvious than that of group A and B(P〈0.05).D((a-jv)O2) and CEO2 of group A,B and C were lower than that of group D.The D((a-jv)O2) and CEO2 of group C were lower than that of group A and B(P〈0.05).Conclusion Dexmedetomidine can reduce the artery and internal jugular bulb oxygen,and reduce the cerebral oxygen uptake in a dose-dependence manner within a certain concentration range.
作者
冯留民
FENG Liumin(Henan Provincial Hospital, Zhengzhou 450000, Chin)
出处
《西北药学杂志》
CAS
2018年第3期404-407,共4页
Northwest Pharmaceutical Journal
关键词
右美托咪定
靶控质量浓度
颅内动脉瘤
动脉-颈内静脉球部血氧差
脑氧摄取率
dexmedetomidine
target concentration
intracranial aneurysm
arterial-internal jugular venous hemorrhage
cerebal oxygen uptake rate