预充液中加入右美托咪定复合全身麻醉在风湿性心脏病患者麻醉中的应用效果

Application effect of dexmedetomidine in prefilled fluid combined with general anesthesia for anesthesia in patients with rheumatic heart disease

目的探讨预充液中加入右美托咪定复合全身麻醉在风湿性心脏病患者麻醉中的应用效果。方法将我院253例风湿性心脏病患者依照麻醉方案的不同分为研究组(n=127)和常规组(n=126)。常规组预充液中加入生理盐水,研究组预充液中加入右美托咪定。比较两组的血流动力学指标、炎性因子水平及MOCA评分。结果 T1、T2时刻,研究组的MAP、HR均低于常规组(P<0.05)。术后2 h,两组IL-6、TNF-α水平均升高,但研究组低于常规组(P<0.05)。术后1 d,两组MOCA评分均降低,但研究组高于常规组(P<0.05)。结论预充液中加入右美托咪定复合全身麻醉对风湿性心脏病患者术中血流动力学影响较小,可减轻机体炎症反应。

Objective To investigate the application effect of dexmedetomidine in prefilled fluid combined with general anesthesia for anesthesia in patients with rheumatic heart disease. Methods A total of 253 patients with rheumatic heart disease in our hospital were divided into study group(n=127) and routine group(n=126) according to different anesthesia schemes. Normal saline was added to the prefilled fluid in the routine group and dextromethoridine was added to the prefilled fluid in the study group. The hemodynamic indexes, inflammatory factors level and MOCA scores of the two groups were compared. Results At T1 and T2, MAP and HR in the study group were lower than those in the routine group(P<0.05).Two hours after operation, the levels of IL-6 and TNF-α in the two groups increased, but those in the study group were lower than the routine group(P<0.05). One day after the operation, the MOCA score of the two groups decreased, but that in the study group was higher than the routine group(P<0.05). Conclusion Dexmedetomidine in prefilled fluid combined with general anesthesia has less effect on hemodynamics in patients with rheumatic heart disease during operation, which can reduce the inflammatory reaction.