盐酸右美托咪定对快通道麻醉患儿血清CRP、PCT、LD、NSE的影响及脑保护作用研究

Effect of Dexmedetomidine Hydrochloride Injection on the Serum CRP,PCT, LD, NSE Levels of Children Undergoing Fast Track Anaesthesia

目的:研究盐酸右美托咪定对快通道麻醉患儿血清C反应蛋白(CRP)、降钙素原(PCT_)、血清乳酸(LD)、神经特性性元烯醇化酶(NSE)的影响及脑保护作用。方法:选择2016年4月至2017年4月在我院进行麻醉手术的61例患者,以抛硬币的方式将其均分为观察组(31例)和对照组(30例)。观察组患者给予盐酸右美托咪定(艾贝宁)行快通道麻醉,而对照组患者采用常规药物行快通道麻醉,比较两组患者治疗前后血清CRP、PCT_水平,T_0(术前1天)、T_1(术后1天)、T_2(术后2天)、T_3(术后3天)、T_4(术后4天)时点血清LD、NSE、脑动静脉血糖差(Ca-j)、乳酸差(AVDL)、脑氧摄取率(O_2Ext)、动脉颈静脉血氧浓度差(Ca-jvO_2)及动脉氧浓度(CaO_2)水平。结果:治疗后,观察组患者的血清CRP及PCT_水平明显低于对照组(P<0.05)。在T_1-T_4各时点,观察组患者的血清LD水平显著低于对照组(P<0.05);在T_3时,观察组患者的血清NSE水平、Ca-j及AVDL水平均显著低于对照组,而O_2Ext、Ca-jvO_2及CaO_2水平均显著高于对照组(P<0.05)。结论:与常规药物进行快通道麻醉相比,艾贝宁快通道麻醉可显著降低患儿血清CRP、PCT_、LD及NSE水平,且能有效改善患儿的脑组织代谢。

Objective： To study the effects of abibin on the serum CRP, PCT, LD, NSE levels and brain protective effect on the children with fast pathway anesthesia. Methods： 61 cases of chidren underwent anesthesia surgery from April 2016 to April 2017 were selected and randomly divided into the observation group and the control group. The observation group was given Ai Benin line fast pathway anesthesia, while the control group were treated with the conventional drugs fast pathway anesthesia. Then the serum levels of CRP and PCT of two groups were compared before and after treatment, the serum levels of LD, NSE, cerebral arteriovenous blood glucose difference（Ca-j）, lactic acid（AVDL） at T0（1 days before operation）, T1（after 1 days）, T2（after 2 days）, T3（after 3 days）, T4（after 4 days）, and the difference of cerebral oxygen uptake rate（O2 Ext）, arterial venous oxygen concentration（Ca-jvO2） and arterial oxygen concentration（CaO2） in the two groups were observed and compared. Results： After treatment, the levels of CRP and PCT in the observation group were lower than those in the control group（P〈0.05）. The level of LD in the observation group was significantly lower than that in the control group（P〈0.05）, and the levels of Ca-j and AVDL in the observation group were significantly lower than those in the control group（P〈0.05）, while the levels of O2 Ext, Ca-jvO2 and CaO2 were significantly higher than those in the control group（P〈0.05）. Conclusion： Abeton fast pathway anesthesia can significantly decrease the serum CRP, PCT, LD and NSE levels of children, and effectively improve the brain tissue metabolism.