右美托咪定对急性颅脑损伤患者脑功能及血流动力学的影响

Effects of dexmedetomidine on cerebral function and hemodynamics in patients with acute craniocerebral injury

目的 研究右美托咪定对急性颅脑损伤患者脑功能及血流动力学产生的影响.方法 抽取2015-09―2017-01登封市人民医院收治的94例接受开颅血肿清除联合去骨瓣减压术急性颅脑损伤病例为研究对象,依据术后镇静药物差异,分为A组与B组各47例,A组予以右美托咪定,B组予以咪达唑仑,比较2组术前与术后24 h格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)、神经元特异烯醇化酶(NSE)浓度 、术后各时刻心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP).结果 术前2组GCS评分及血清NSE浓度对比无显著性差异(P>0.05);术后24 h,A组GCS评分与GOS评分显著高于B组,NSE浓度明显低于B组(P<0.05);T0时刻,2组HR、SBP、DBP及MAP对比无显著性差异(P>0.05);T1、T2、T3时刻,A组HR、SBP、DBP及MAP均明显小于B组(P<0.05).结论 右美托咪定治疗可保护急性颅脑损伤患者脑功能,并维持血流动力学指标的稳定,优化预后.

Objective To study the effects of dexmedetomidine on cerebral function and hemodynamics in patients with acute craniocerebral injury.Methods A total of 94 cases of acute craniocerebral injury admitted to Dengfeng People's hospital from September 2015 to January 2017 were selected as the study objects.According to the difference of postoperative sedative drugs,47 cases were divided into group A and group B.Group A was given dexmedetomidine,group B was given midazolam.Comparison of Glasgow coma score(GCS),Glasgow prognosis score(GOS),concentration of neuron specific enolase(NSE),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)and average arterial pressure(MAP)at Preoperative and postoperative 24 h in the 2 groups.Results There was no significant difference in GCS score and serum NSE concentration between the two groups at Preoperative(P>0.05);GCS score and GOS score of group A were significantly higher than that of group B,and NSE concentration was significantly lower than that of group B at postoperative 24 h(P<0.05);At T0,there was no significant difference in HR,SBP,DBP and MAP between the two groups(P>0.05);At time T1,T2 and T3,HR,SBP,DBP and MAP in group A were significantly lower than those in group B(P<0.05).Conclusion Dexmedetomidine can protect brain function,maintain hemodynamic index stability and optimize prognosis in patients with acute craniocerebral injury.It has positive application value in clinical practice.