右美托咪定在间接暴力致颅脑损伤手术麻醉中的脑保护作用及对患者预后的影响(1)
[摘要] 目的 探讨右美托咪定在间接暴力致颅脑损伤手术麻醉中的脑保护作用及其对患者预后的影响。 方法 选取2015年11月～2017年9月于我院就诊的间接暴力致颅脑损伤患者150例，按随机数字表法分为对照组和观察组。观察组在麻醉诱导前给予右美托咪定静脉滴注，对照组给予等剂量的生理盐水。观察并比较两组患者脑损伤、血糖相关指标及患者预后。 结果 组内比较结果显示，两组患者在麻醉诱导前的神经元特异性烯醇化酶(NSE)、酸性钙结合蛋白(S-100β)表达水平均低于术后24 h(P<0.05);对照组患者在麻醉诱导前的血糖、空腹胰岛素水平低于麻醉后60 min(P<0.05)。组间比较结果显示，观察组在术后24 h的NSE、S-100β指标表达水平均低于对照组(P<0.05);观察组在麻醉后60 min的血糖、空腹胰岛素水平低于对照组(P<0.05);观察组患者GOS、ADL评分高于对照组(P<0.05)。 结论 右美托咪定应用于间接暴力致颅脑损伤手术麻醉中，可有效缓解患者脑损伤并改善患者预后。
[关键词] 右美托咪定;颅脑损伤;脑保护;预后
[中图分类号] R651.15;R614 [文献标识碼] B [文章编号] 1673-9701(2020)29-0133-04
[Abstract] Objective To explore the cerebral protection effect of dexmedetomidine in the surgical anesthesia of craniocerebral injury caused by indirect violence and its influence on the prognosis of patients. Methods A total of 150 patients with craniocerebral injury caused by indirect violence treated in our hospital from November 2015 to September 2017 were enrolled and divided into the control group and observation group according to the random number table method. The observation group was given intravenous infusion of dexmedetomidine before anesthesia induction while the control group was given an equal dose of physiological saline. The cerebral injury and blood glucose related indicators and the prognosis of patients of the two groups were observed and compared. Results Self-comparison showed that the expression levels of neuron-specific enolase(NSE) and acid-calcium binding protein(S-100β) before anesthesia induction were lower than those 24 hours after surgery in both groups(P<0.05) and that the blood glucose and fasting insulin levels before anesthesia induction were lower than those 60 minutes after anesthesia in the control group(P<0.05). Between-group comparison showed that the expression levels of NSE and S-100β in the observation group were lower than those in the control group 24 hours after operation(P<0.05)，that the blood glucose and fasting insulin levels in the observation group were lower than those in the control group 60 minutes after anesthesia(P<0.05)，and the scores of GOS and ADL in the observation group were higher than those in the control group. Conclusion The application of Dexmedetomidine in the surgical anesthesia of craniocerebral injury caused by indirect violence can effectively alleviate cerebral injury and improve the prognosis of patients.
[Key words] Dexmedetomidine; Craniocerebral injury; Cerebral protection; Prognosis, 百拇医药(胡国强 孙依娜 曹东航)
[关键词] 右美托咪定;颅脑损伤;脑保护;预后
[中图分类号] R651.15;R614 [文献标识碼] B [文章编号] 1673-9701(2020)29-0133-04
[Abstract] Objective To explore the cerebral protection effect of dexmedetomidine in the surgical anesthesia of craniocerebral injury caused by indirect violence and its influence on the prognosis of patients. Methods A total of 150 patients with craniocerebral injury caused by indirect violence treated in our hospital from November 2015 to September 2017 were enrolled and divided into the control group and observation group according to the random number table method. The observation group was given intravenous infusion of dexmedetomidine before anesthesia induction while the control group was given an equal dose of physiological saline. The cerebral injury and blood glucose related indicators and the prognosis of patients of the two groups were observed and compared. Results Self-comparison showed that the expression levels of neuron-specific enolase(NSE) and acid-calcium binding protein(S-100β) before anesthesia induction were lower than those 24 hours after surgery in both groups(P<0.05) and that the blood glucose and fasting insulin levels before anesthesia induction were lower than those 60 minutes after anesthesia in the control group(P<0.05). Between-group comparison showed that the expression levels of NSE and S-100β in the observation group were lower than those in the control group 24 hours after operation(P<0.05)，that the blood glucose and fasting insulin levels in the observation group were lower than those in the control group 60 minutes after anesthesia(P<0.05)，and the scores of GOS and ADL in the observation group were higher than those in the control group. Conclusion The application of Dexmedetomidine in the surgical anesthesia of craniocerebral injury caused by indirect violence can effectively alleviate cerebral injury and improve the prognosis of patients.
[Key words] Dexmedetomidine; Craniocerebral injury; Cerebral protection; Prognosis, 百拇医药(胡国强 孙依娜 曹东航)