七氟烷联合右美托咪定对颅内动脉瘤栓塞术患者血流动力学及神经功能的影响

Influence of Sevoflurane Combined with Dexmedetomidine on Hemodynamics and Neural Function in Patients with Intracranial Aneurysm Embolization

目的:研究七氟烷联合右美托咪定对颅内动脉瘤栓塞术患者血流动力学以及神经功能的效用。方法:选取2018年4月~2019年6月在本院行栓塞术的100例颅内动脉瘤患者作为研究对象,按随机数字表法分为观察组和对照组,每组50例。对两组患者进行栓塞术治疗,对照组以七氟烷进行麻醉维持,观察组在此基础上予以右美托咪定联合治疗,对两组心率(HR)、心排出量(CO)、动脉压(MAP)等动力学指标进行监测,参照美国国立卫生研究院卒中量表(NIHSS)对患者的神经缺损情况,及简易精神状态检查量表(MMSE)对患者的精神状态进行评定。结果:与对照组比较,观察组的不良反应程度降低(P<0.05);观察组各项恢复所用时间均短于对照组,警觉-镇静(OAAS)评分高于对照组(P<0.05);血流动力学方面,两组HR、CO、MAP等动力学指标在T2和T3低于T1阶段,而在T4时又有所恢复,两组间无统计学差异(P>0.05);但观察组在T2和T3时的各血流指标高于对照组(P<0.05);精神功能方面,治疗后观察组的NIHSS与MMSE评分均优于对照组。通过对生存函数分析,观察组的生存率高于对照组(P<0.05)。结论:七氟烷联合右美托咪定可使颅内动脉瘤栓塞术患者的血流动力学保持稳定状态,对于患者的精神功能同样具有改善效果。

Objective:To explore the influence of the anesthesia mode of sevoflurane combined with dexmedetomidine on hemodynamics and neurological function in patients with intracranial aneurysm embolization.Methods:A total of 100 patients with intracranial aneurysms who underwent embolization in our hospital from April 2018 to June 2019 were selected as research subjects.According to the random number table method,it was divided into the observation group and the control group,50 cases in each group.The patients in both groups were treated with embolization.The control group was maintained with sevoflurane anesthesia,and the observation group was given dexmedetomidine combined anesthesia on this basis.Then the dynamic indexes such as heart rate(HR),cardiac output(CO)and arterial pressure(MAP)of the two groups were monitored.Neurological deficits were measured according to the National Institutes of Health Stroke Scale(NIHSS).The mental state of patients was assessed by the mini mental state examination scale(MMSE).Results:Compared with the control group,the adverse reactions in the observation group were significantly lower(P<0.05).The recovery time of the observation group was lower than that of the control group,and the alert sedation score(OAAS)was higher than that of the control group(P<0.05).In terms of hemodynamics,the related hemodynamics indexes of HR,CO,MAP,etc.in the two groups were obviously lower at T2 and T3 stages than those in the T1 stage,but recovered again at T4 stage.There was no significant difference between the two groups(P>0.05).However,the blood flow indexes of the observation group at T2 and T3 stages were higher than those of the control group(P<0.05).In mental function,the NIHSS and MMSE scores of the observation group after treatment were better than those of the control group.By survival function analysis,the survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion:The anesthesia mode of sevoflurane combined with dexmedetomidine can keep the hemodynamics of patients with intracranial aneurysm embolization in a stable state,and also improve the mental function of patients.