丙泊酚结合右美托咪定对神经外科脑外伤患者的麻醉效果

Anesthesia Effect of Propofol Combined with Dexmedetomidine in Neurosurgery Brain Trauma Patients

目的探讨丙泊酚结合右美托咪定对神经外科脑外伤患者的麻醉效果。方法选取鹤壁市人民医院2022年2月至2023年2月收治的78例脑外伤患者,根据随机数字表法分为对照组和观察组,各39例。对照组接受丙泊酚麻醉,观察组接受丙泊酚结合右美托咪定麻醉。比较两组血流动力学指标、应激反应指标、脑损伤标志物、不良反应。结果对照组气管插管时(T_(1))、切皮时(T_(2))、拔管时(T_(3))、拔管后1 h(T_(4))心率、收缩压、舒张压较术前(T_(0))升高,且高于观察组同时间点(P<0.05);与T_(0)相比,术后24 h(T_(5))两组低氧诱导因子1α(HIF-1α)、促肾上腺皮质激素(ACTH)水平降低,且观察组低于对照组(P<0.05),白细胞介素-10(IL-10)水平升高,且观察组高于对照组(P<0.05);与T_(0)相比,T_(5)时两组S100β蛋白、神经元特异性烯醇化酶(NSE)水平均升高,且观察组低于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论丙泊酚结合右美托咪定对神经外科脑外伤患者的麻醉效果确切,可维持患者血流动力学稳定,减轻机体应激反应和脑损伤,安全性较高。

Objective To investigate the anesthesia effect of propofol combined with dexmedetomidine in neurosurgery brain trauma patients.Methods A total of 78 patients with brain injury admitted to Hebi People’s Hospital from February 2022 to February 2023 were selected and randomly divided into control group and observation group,with 39 cases in each group.The control group was anesthetized with propofol,and the observation group was anesthetized with propofol combined with dexmedetomidine.Hemodynamic indexes,stress response indexes,markers of brain injury and adverse reactions were compared between the two groups.Results The heart rate,systolic blood pressure and diastolic blood pressure of the control group at tracheal intubation(T_(1)),skin cutting(T_(2)),extubation(T_(3))and 1 hour after extubation(T_(4))were higher than those of preoperative(T_(0)),and which were higher than the observation group at the same time point(P<0.05).Compared with T_(0),the levels of hypoxia-inducing factor 1α(HIF-1α)and adrenocorticotropic hormone(ACTH)24 hours after surgery(T_(5))of the two groups were decreased,and the observation group was lower than the control group(P<0.05),and the level of interleukin-10(IL-10)was increased,while the observation group was higher than that in the control group(P<0.05).Compared with T_(0),the levels of S100βprotein and neuron-specific enolase(NSE)in both groups were increased at T_(5),and the observation group was lower than the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Propofol combined with dexmedetomidine has a definite anesthetic effect in neurosurgery patients with brain trauma,which can maintain the hemodynamic stability of patients,reduce the stress response of the body and brain injury,with high safety.