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目标导向血流动力学管理对高危心血管患者术后心肌损伤的影响 被引量:2
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作者 欧阳杰 纳雪晴 +5 位作者 屈启才 陶建平 周臣 陈建春 马军 思永玉 《中国现代医学杂志》 CAS 2020年第19期54-58,共5页
目的研究目标导向血流动力学管理对高危心血管患者术后心肌损伤的影响。方法选取择期行开腹手术的高危心血管患者44例作为研究对象。随机分为两组:传统管理组和目标管理组,常规监测并快速诱导插管,术中管理:传统管理组由主治以上麻醉医... 目的研究目标导向血流动力学管理对高危心血管患者术后心肌损伤的影响。方法选取择期行开腹手术的高危心血管患者44例作为研究对象。随机分为两组:传统管理组和目标管理组,常规监测并快速诱导插管,术中管理:传统管理组由主治以上麻醉医生根有创动脉血压(ABP)和中心静脉压(CVP),以经验调控输液量及给予血管活性药物或正性肌力药物;目标管理组行心排量监测,根据心指数(CI)、每博量变化值(△SV)、舒张压(DBP)等指标按设定流程调控输液量及给予血管活性药物和正性肌力药物。分别记录两组一般情况、术前、术后24 h、术后48 h心肌损伤标志物水平,住院期间心肌梗死发生情况以及术后30 d预后情况。结果不同时间点两组患者肌钙蛋白T、CKMB及BNP均有差异(P<0.05)。组间肌钙蛋白T有差异(P<0.05);两组患者肌钙蛋白T和BNP变化趋势有差异(P<0.05);两组住院期间心梗发生率和术后30 d存活率比较,差异无统计学意义(P>0.05)。结论应用CI联合△SV对高危心血管患者进行血流动力学管理,可降低其术后肌钙蛋白T水平。 展开更多
关键词 目标导向治疗 心肌损伤 肌钙蛋白T 围手术期
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Effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery of gynecological laparoscopic operation 被引量:1
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作者 jian-chun chen chen Zhou +2 位作者 Qi-Cai Qu Jie Ouyang Jun Ma 《Journal of Hainan Medical University》 2017年第14期54-57,共4页
Objective:To study the effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery period of gynecological laparoscopic operation.Methods:A total of 86 patients who received laparoscopic ... Objective:To study the effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery period of gynecological laparoscopic operation.Methods:A total of 86 patients who received laparoscopic operation in the Second Affiliated Hospital of Kunming Medical University between June 2014 and December 2016 were selected and randomly divided into the dexmedetomidine combined with oxycodone group (DO group) and control group (C group). Before anesthesia induction (T1), at the end of the surgery and before micro pump injection of dexmedetomidine and oxycodone hydrochloride (T2) and in recovery period (T3), serum levels of pituitary-target gland axis-related hormones, vascular activity-related hormones and oxidative stress-related molecules were determined.Results: At T1 and T2, serum TSH, T3, T4, ACTH, Cor, NE, E, ADH, AT-II, ROS, MDA, SOD and HO-1 levels of DO group were not significantly different from those of C group;at T3, serum TSH, T3, T4, ACTH, Cor, NE, E, ADH, AT-II, ROS and MDA levels of DO group were significantly lower than those of C group while SOD and HO-1 levels were significantly higher than those of C group.Conclusions: Dexmedetomidine combined with oxycodone can inhibit the systemic stress response in recovery of gynecological laparoscopic operation. 展开更多
关键词 LAPAROSCOPY Emergence AGITATION DEXMEDETOMIDINE OXYCODONE HYDROCHLORIDE Stress response
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