右美托咪定应用Stanford A型主动脉夹层行改良“孙氏”手术对围术期患者心功能及认知功能的影响

Effects of Dexmedetomidine on Cardiac Function and Cognitive Function in Patients with Stanford Type A Aortic Dissection Undergoing Modified"Sun’s"Operation

目的探讨右美托咪定应用Stanford A型主动脉夹层行对围术期患者心功能及认知功能的影响。方法选择2018年6月—2020年6月山西白求恩医院拟行改良“孙氏”手术治疗的急性主动脉夹层患者60例,随机将患者分为对照组(C组)和右美托咪定组(D组),每组30例。D组于麻醉诱导后静脉注射右美托咪定,C组静注等量生理盐水。比较两组患者不同时间点心功能指标及围术期认知功能变化。结果D组患者T3、T4和T5时间点NT-proBNP、CK-MB和cTnI水平显著低于C组,差异有统计学意义(P<0.05)。T5时两组患者MMSE评分均较T1时均明显升高,且D组MMSE评分(27.87±2.14)分高于C组(24.72±2.26)分,差异有统计学意义(t=5.543,P<0.05)。结论应用右美托咪定可改善术后心功能及认知功能,具有临床应用价值。

Objective To investigate the effect of dexmedetomidine on cardiac function and cognitive function in patients with Stanford type A aortic dissection during the perioperative period.Methods From June 2018 to June 2020,60 patients with acute aortic dissection planned to undergo modified"sun′s"surgery in Shanxi Bethune hospital were selected.The patients were randomLy divided into control group(group C)and dexmedetomidine group(group D),30 cases in each group.Group D was given intravenous injection of dexmedetomidine after induction of anesthesia,and group C was given the same volume of normal saline.The functional indexes of dim sum and the changes of cognitive function during the perioperative period were compared between the two groups of patients.Results The levels of NT-proBNP,CK-MB and c TnI at T3,T4 and T5 time points in group D were significantly lower than those in group C,and the difference was statistically significant(P<0.05).The MMSE scores of the two groups at T5 were significantly higher than those at T1,and the MMSE scores of group D(27.87±2.14)points were higher than those of group C(24.72±2.26)points,and the difference was statistically significant(t=5.543,P<0.05).Conclusion Dexmedetomidine can improve postoperative cardiac function and cognitive function,which has clinical application value.