右美托咪定对重症颅脑损伤患者镇静、生命体征及脑氧代谢的影响

Effects of dexmedetomidine on sedation,vital signs and cerebral oxygen metabolism in patients with severe craniocerebral injury

目的分析右美托咪定对重症颅脑损伤患者镇静、生命体征及脑氧代谢的影响。方法100例重症颅脑损伤患者,采用随机数字法分为对照组与观察组,每组50例。对照组术后给予常规综合治疗,观察组在常规治疗基础上加用右美托咪定静脉泵注。分析2组患者的术后镇静、免疫功能及脑氧代谢各项指征的变化。结果观察组在术后12h、24h、48h、72h的内的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2)均明显低于对照组(P<0.05);与术后0h比较,2组患者在术后12h、24h、48h、72h的Ramsay评分、动脉-颈内静脉血氧含量差(AVDO2)、脑氧摄取率(CERO2)均明显下降,格拉斯哥昏迷量表(GCS)评分、颈静脉球部血氧饱和度(SjvO2)均明显增加,但观察组的以上指标明显优于对照组(P<0.05)。结论重症颅脑损伤患者在术后加用右美托咪定可明显改善术后镇静的效果,同时稳定患者生命体征及意识状态,增强脑氧代谢,安全性高。

Objective To investigate the effects of dexmedetomidine on sedation,vital signs and cerebral oxygen metabolism in patients with severe craniocerebral injury.Methods One hundred patients with evere craniocerebral injury were randomly divided into control group and observation group,with 50 cases in each group.The patients in control group were given conventional comprehensive treatment,however,the patients in observation group,on the basis of control group,were treated by dexmedetomidine intravenous injection.The postoperative sedation effects,immune function,and changes of cerebral oxygen metabolism indexes were observed and compared between the two groups.Results The levels of heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),and pulse oxygen saturation(SpO 2)in observation group were significantly lower than those in control group at 12h,24h,48h,and 72h after surgery(P<0.05).As compared with those at 0h after operation,the Ramsay scores,AVDO 2,and CERO 2 at 12h,24h,48h and 72h after operation were significantly decreased in both groups,but the Glasgow Coma Scale(GCS)scores,and SjvO2 levels were increased significantly,moreover,the above indexes in observation group were superior to those in control group(P<0.05).Conclusion The application of dexmedetomidine in patients with severe craniocerebral injury after operation can significantly improve postoperative sedation effects,at the same time,which can stabilize the patient’s vital signs and consciousness,enhance brain oxygen metabolism,with higher safety.