不同剂量右美托咪定在脑瘫选择性脊神经后根切断术中的应用效果及对血清S100β蛋白、NSE水平的影响

Application effect of different doses of dexmedetomidine in selective posterior rhizotomy of cerebral palsy and its influence on the levels of serum S100β protein and NSE

目的探讨不同剂量右美托咪定(Dex)在脑瘫选择性脊神经后跟切断术中的应用效果及对血清S100β蛋白、NSE水平的影响。方法将68例脑瘫患儿随机分为观察组与对照组,各34例。观察组麻醉诱导前输注0.5μg/kg的Dex,术中以0.3μg/(kg·h)维持量至手术结束;对照组麻醉诱导前输注1.0μg/kg的Dex,术中以0.5μg/(kg·h)维持量至手术结束。比较两组的临床效果。结果 T1、T2时,两组的MAP、HR均低于T0时,但观察组高于对照组(P<0.05)。治疗后,两组的NSE及S100β蛋白水平均低于治疗前(P<0.05)。两组患儿用药前、后EEMG振幅保留率和潜伏期比较,差异无统计学意义(P>0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在脑瘫选择性脊神经后根切断术中不同剂量Dex均可调低NSE及S100β蛋白水平,而以0.5μg/kg输注,0.3μg/(kg·h)维持麻醉时患儿血流动力学更加平稳,同时不增加不良反应且对EEMG检测无明显影响。

Objective To investigate the application effect of different doses of dexmedetomidine(Dex) in selective posterior rhizotomy of cerebral palsy and its influence on serum S100β protein and NSE levels. Methods A total of 68 children with cerebral palsy were randomly divided into observation group and control group, with 34 cases in each group. The observation group received 0.5 μg/kg Dex infusion before anesthesia induction, during the operation, 0.3μg/(kg·h) was used as maintenance until the end of the operation;the control group received 1.0 μg/kg Dex infusion before anesthesia induction, during the operation, 0.5 μg/(kg·h) was used as maintenance until the end of the operation. The clinical effects of the two groups were compared. Results At T1 and T2, the MAP and HR of the two groups were lower than those at T0, but those in the observation group were higher than the control group(P <0.05).After treatment, NSE and S100β protein levels of the two groups were lower than those before treatment(P <0.05).There were no significant differences in EEMG amplitude retention rate and latency between the two groups before and after treatment(P >0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P >0.05). Conclusion Different doses of Dex can reduce the levels of NSE and S100β protein in the selective posterior rhizotomy of cerebral palsy, while the hemodynamics is more stable when 0.5 μg/kg infusion and0.3 μg/(kg·h) anesthesia is maintained, and without increasing adverse reactions and no significant effect on the detection of EEMG.