丙泊酚联合右美托咪定对颅脑损伤手术患者的影响

Effect of Propofol Combined with Dexmedetomidine in Patients Undergoing Craniocerebral Injury Surgery

目的:研究丙泊酚联合右美托咪定对颅脑损伤手术患者的影响。方法:选取2021年6月-2022年1月121例厦门市第三医院颅脑损伤手术患者。根据随机数字表法将其分为观察组(n=61)和对照组(n=60)。两组患者入手术室后给予常规措施,观察组给予丙泊酚联合右美托咪定麻醉,对照组给予丙泊酚麻醉。比较两组睁眼时间和自主呼吸恢复时间,术前,术后1、3、7 d脑血流动力学指标、颅内压水平及不良反应。结果:观察组自主呼吸恢复时间与睁眼时间均早于对照组(P<0.05)。术后1、3、7 d,观察组血流峰值流速(Vs)、平均血流速度(Vm)均显著高于对照组,搏动指数(PI)值则显著低于对照组(P<0.05)。术后1、3、7 d,观察组颅内压水平明显低于对照组(P<0.05)。观察组躁动、呛咳发生率及不良反应总发生率均明显低于对照组(P<0.05)。结论:丙泊酚联合右美托咪定能够有效缩短颅脑损伤手术患者自主呼吸恢复时间和苏醒时间,降低颅内压,改善脑血流动力学,从而改善患者预后。

Objective:To study the effect of Propofol combined with Dexmedetomidine in patients undergoing craniocerebral injury surgery.Method:A total of 121 patients undergoing craniocerebral injury surgery in Xiamen Third Hospital from June 2021 to January 2022 were selected.They were divided into observation group (n=61) and control group (n=60) according to random number table method.The patients in the two groups were given routine measures after entering the operating room.The observation group was given Propofol combined with Dexmedetomidine anesthesia,and the control group was given Propofol anesthesia.The eye opening time and recovery time of spontaneous respiration,the cerebral hemodynamic indexes,intracranial pressure levels before surgery,1,3,7 d after surgery and adverse reactions were compared between the two groups.Result:The eye opening time and recovery time of spontaneous respiration in the observation group were earlier than those in the control group (P<0.05).The peak velocity (Vs) and mean velocity (Vm) in the observation group were significantly higher than those in the control group,while the pulsatility index (PI) value was significantly lower than that in the control group 1,3,7 d after surgery (P<0.05).The level of intracranial pressure in the observation group was significantly lower than that in the control group 1,3,7 d after surgery (P<0.05).The incidences of restlessness,cough and total adverse reactions in the observation group were significantly lower than those in the control group (P<0.05).Conclusion:Propofol combined with Dexmedetomidine can effectively shorten the recovery time and recovery time of spontaneous respiration,reduce intracranial pressure,improve cerebral hemodynamics,and improve the prognosis of patients undergoing craniocerebral injury surgery.