摘要
目的:旨在探讨右美托咪定唤醒麻醉对脑功能区胶质瘤切除术患者的影响效果。方法:选取我科2020年1月至2022年12月期间脑功能区胶质瘤切除术患者98例,随机将其分为接受全身麻醉(General anesthesia,GA)的对照组(n=49)和接受清醒麻醉(Awake anesthesia,AA)的观察组(n=49),比较两组患者的麻醉质量、脑保护效应、脑脊液氨基酸水平和术后谵妄发生率。结果:观察组唤醒时间低于对照组,唤醒程度以及清醒后的质量均高于对照组(P<0.05);麻醉后,两组患者的血清S100β钙结合蛋白(S100 beta calcium binding protein,S100β)和神经元特异性烯醇化酶(Neuron-specific enolase,NSE)水平均高于麻醉诱导前,且观察组患者低于对照组(P<0.05);观察组患者术后的抑制性氨基酸γ-氨基丁酸(Gamma-aminobutyric acid,GABA)水平高于对照组,兴奋性氨基酸天门冬氨酸(Aspartic acid,Asp)、谷氨酸(Glutamate,Glu)水平均低于对照组(P<0.05);两组术后谵妄发生率无统计学差异。结论:右美托咪定在唤醒麻醉手术过程中,可提高脑功能区胶质瘤患者的麻醉质量,同时还能改善患者脑脊液氨基酸水平和脑保护效应,减少脑组织损伤。
Objective:To investigate the effect of dexmedetomidine awakening anesthesia on patients with glioma resection in brain function area.Methods:Ninety-eight patients with glioma resection in brain function areas were selected in our department from January 2020 to December 2022,and divided into a control group receiving General anesthesia(GA)(n=49)and a control group receiving Awake anesthesia(n=49)randomly.Anesthesia quality,cerebral protective effects,cerebrospinal fluid amino acid levels,and postoperative delirium incidence were compared between the two groups.Results:The waking time of the observation group was lower than that of the control group,the waking degree and waking quality were better than those of the control group(P<0.05).After anesthesia,serum levels of S100 beta calcium binding protein(S100β)and Neuron-specific enolase(NSE)in two groups were higher than those before anesthesia induction;and their levels in observation group were lower than those in control group(P<0.05);The level of inhibitory amino acidγ-aminobutyric acid(GABA)in observation group was higher than that in control group,and the levels of excitatory amino acid aspartic acid(Asp)and Glutamate(Glu)were lower than those in control group(P<0.05).There was no statistical significance difference between the incidence of postoperative delirium in two groups.Conclusion:Dexmedetomidine can improve the quality of anesthesia in patients with glioma in cerebral functional area during arousal anesthesia surgery,and can also improve the level of amino acids in cerebrospinal fluid and brain protective effect,and reduce brain tissue injury.
作者
郭志鹏
冯锋
王其敏
Guo Zhi-peng;Feng Feng;Wang Qi-min(Department of Anesthesiology and Perioperative Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
