右美托咪定在非体外循环冠状动脉旁路移植术中的应用

The Effect of Dexmedetomidine for Off-pump Coronary Artery Bypass Grafting During Operation

目的探讨术中应用右美托咪定对于非体外循环冠状动脉旁路移植术(OPCABG)患者的影响。方法选取2014年10月—2017年10月我院80例OPCABG患者作为研究对象,将其随机均分为观察组和对照组,每组各40例。观察组术中给予右美托咪定。对照组给予生理盐水。于多个时间点对各项血流动力学指标进行详细记录。术前1天、术后7天评估患者的认知功能。结果对照组多个时间点心率、平均动脉压发生显著变化,差异具有统计学意义(P<0.05);与对照组比较,观察组多个时间点心率、平均动脉压显著下降,差异具有统计学意义(P<0.05)。对照组POCD发生率32.5%,高于观察组的7.5%,差异具有统计学意义(P<0.01)。结论术中应用右美托咪定可使OPCABG患者围术期血流动力学得以更加稳定,并使得POCD发生率显著降低。

Objective To explore the effects of dexmedetomidine for OPCABG during operation. Methods 80 cases of OPCABG in our hospital from October 2014 to October 2017 were selected as research subjects. They were randomly divided into the observation group and the control group, 40 cases in each group. Right metodetidin was given to the observation group during the operation. The control group was given saline. Hemodynamic parameters were recorded in detail at various time points. Cognitive function was assessed 1 day before operation and 7 days after operation. Results There were signifcant changes in the rate of snack and mean arterial pressure in the control group at various times （P 〈 0.05）. Compared with the control group, the observation group had a signifcant decrease in the rate of snack and mean arterial pressure at various times （P 〈 0.05）. The incidence of POCD in the control group was 32.5%, higher than that in the observation group （7.5%）, and the difference was statistically significant （P 〈 0.01）. Conclusion The application of dexmedetomidine for off-pump coronary artery bypasses grafting during operation have more stable hemodynamics and less incidence of POCD.