[1]张 磊.右美托咪定、异丙酚复合麻醉对脑肿瘤切除手术患者的脑保护效果比较[J].医学信息,2023,36(24):106-109.[doi:10.3969/j.issn.1006-1959.2023.24.023]
　ZHANG Lei.Comparison of Brain Protection Effects of Dexmedetomidine and Propofol Combined Anesthesia on Patients Undergoing Brain Tumor Resection Surgery[J].Journal of Medical Information,2023,36(24):106-109.[doi:10.3969/j.issn.1006-1959.2023.24.023]
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右美托咪定、异丙酚复合麻醉对脑肿瘤切除手术患者的脑保护效果比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年24期
页码:
106-109
栏目:
论著
出版日期:
2023-12-15

文章信息/Info

Title:
Comparison of Brain Protection Effects of Dexmedetomidine and Propofol Combined Anesthesia on Patients Undergoing Brain Tumor Resection Surgery
文章编号:
1006-1959（2023）24-0106-04
作者:
张 磊
（天津市北辰区中医医院麻醉科，天津 300499）
Author(s):
ZHANG Lei
(Department of Anesthesiology,Tianjin Beichen District Hospital of Traditional Chinese Medicine,Tianjin 300499,China)
关键词:
脑肿瘤切除手术; 右美托咪定; 异丙酚; 脑保护; 血流动力学
Keywords:
Brain tumor resection surgery; Dextrmedetomidine; Propofol; Brain protection effect; Hemodynamics
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2023.24.023
文献标志码:
A
摘要:
目的 对比右美托咪定（Dex）、异丙酚（Pro）复合麻醉对脑肿瘤切除手术患者的脑保护效果。方法 选取2017年3月-2022年10月于我院行脑肿瘤切除手术的86例患者为研究对象，按照随机数字表法分为Dex组（43例）和Pro组（43例），Dex组采用右美托咪定复合麻醉，Pro组则应用异丙酚复合麻醉，比较两组麻醉诱导前（T0）、麻醉诱导后即刻（T1）、硬脑膜切开时（T2）、手术结束即刻（T3）、术后6 h（T4）的血流动力学指标[平均动脉压（MAP）、心率]，同时监测患者T0、T3、术后24 h（T5）、术后3 d（T6）的脑损伤指标[神经元特异性烯醇化酶（NSE）、中枢神经特异蛋白（S-100β）]，并统计其麻醉起效时间、苏醒时间、气管拔管时间及两组麻醉不良反应。结果 相较于T0，两组T1、T2、T3时HR、MAP指标均有升高（P＜0.05）；但Dex组T1、T2、T3时HR、MAP水平低于Pro组（P＜0.05）；相较于T0，两组T3、T5时NSE、S-100β指标均有升高（P＜0.05），但Dex组T3、T5时NSE、S-100β水平低于Pro组（P＜0.05）。Dex组麻醉起效时间、苏醒时间、气管拔管时间均短于Pro组（P＜0.05）；Dex组麻醉不良反应发生率小于Pro组（P＜0.05）。结论 Dex复合麻醉可降低脑肿瘤切除手术患者的血流动力学波动，减少脑组织损伤，其脑保护效果优于Pro复合麻醉，且麻醉起效更快、苏醒时间更短。
Abstract:
Objective To compare the brain protective effects of dexmedetomidine (Dex) and propofol (Pro) combined anesthesia in patients undergoing brain tumor resection.Methods A total of 86 patients who underwent brain tumor resection in our hospital from March 2017 to October 2022 were selected as the research objects. According to the random number table method, they were divided into Dex group (43 patients) and Pro group (43 patients). Dex group was treated with dexmedetomidine combined anesthesia, and Pro group was treated with propofol combined anesthesia. The hemodynamic indexes [mean arterial pressure (MAP), heart rate] of the two groups before anesthesia induction (T0), immediately after anesthesia induction (T1), dural incision (T2), immediately after operation (T3) and 6 h after operation (T4) were compared. At the same time, the brain injury indexes [neuron-specific enolase (NSE), central nervous system specific protein (S-100β)] of patients at T0, T3, 24 h after operation (T5) and 3 d after operation (T6) were monitored, and the onset time of anesthesia, recovery time, extubation time and adverse reactions of the two groups were counted.Results Compared with T0, the levels of HR and MAP at T1, T2 and T3 in the two groups were increased (P<0.05). However, the levels of HR and MAP at T1, T2 and T3 in Dex group were lower than those in Pro group (P<0.05). Compared with T0, the levels of NSE and S-100β at T3 and T5 in the two groups increased (P<0.05), but the levels of NSE and S-100β at T3 and T5 in the Dex group were lower than those in the Pro group (P<0.05). The onset time of anesthesia, recovery time and tracheal extubation time in the Dex group were shorter than those in the Pro group (P<0.05). The incidence of anesthesia adverse reactions in the Dex group was lower than that in the Pro group (P<0.05).Conclusion Dex combined anesthesia can reduce hemodynamic fluctuations and brain tissue damage in patients undergoing brain tumor resection. Meanwhile, its brain protection effect is better than that of Pro combined anesthesia, and the onset of anesthesia is faster and the recovery time is shorter.

参考文献/References:

[1]尹健,张宏燕,王晓娜,等.右美托咪定联合利多卡因对颅脑肿瘤手术患者炎性因子、氧化应激和免疫功能的影响[J].河北医药,2021,43(1):105-107,111.[2]包娜日素,韩亚升,张生茂,等.右美托咪定对丙泊酚联合瑞芬太尼全麻下脑功能区肿瘤切除术患者唤醒试验的影响[J].神经损伤与功能重建,2022,17(3):171-173.[3]曹喜华,王帅,徐国亭,等.右美托咪定全身麻醉对老年肿瘤手术患者脑血流动力学和应激反应的影响研究[J].实用癌症杂志,2021,36(11):1909-1912.[4]佘乾斌,刘继明.右美托咪定联合利多卡因对颅内幕上肿瘤切除术患者的脑保护作用[J].贵州医药,2021,45(8):1274-1275.[5]李媛,郭悦平,周期,等.右美托咪定复合丙泊酚对颅脑动脉瘤介入手术患者术后神经损伤标志物的影响[J].川北医学院学报,2021,36(8):994-998.[6]张立群,韩俊,陈祖涛.DEX与异丙酚在中重度颅脑损伤患者镇痛镇静中的应用效果及对血清β-内啡肽、炎症因子、脑氧代谢的影响[J].创伤外科杂志,2018,20(12):887-891.[7]姜锋,张莉,梁冲.右美托咪定与丙泊酚对颅脑外伤患者的镇静效果、血流动力学及脑保护作用比较[J].中国现代医学杂志,2020,30(22):86-90.[8]吉芳,张静静,张冰.右美托咪定对脑肿瘤手术患者的麻醉效果分析[J].中国现代医学杂志,2020,30(22):75-80.[9]尹健,张宏燕,王晓娜,等.右美托咪定联合利多卡因对颅脑肿瘤手术患者神经功能、认知功能的影响[J].河北医药,2020,42(21):3293-3296.[10]孙晓梅,陈森,李长生.右美托咪定对老年脑肿瘤切除患者围术期脑氧代谢的影响和脑损伤的保护作用[J].现代肿瘤医学,2020,28(24):4334-4338.[11]李清军,刘峰,杨晓艳.右美托咪定联合瑞芬太尼、丙泊酚对神经外科手术麻醉效果及Nogo-A、低氧诱导因子1α表达的影响[J].广西医科大学学报,2020,37(5):922-928.[12]王昕,吴向群,刘祥.右美托咪定对异丙酚麻醉所致新生大鼠脑损伤的保护作用及机制[J].基因组学与应用生物学,2020,39(3):1275-1282.[13]周先烁.静脉注射右美托咪啶辅助全身麻醉的效果及麻醉后不良反应发生率分析[J].中华保健医学杂志,2020,22(1):89-90,92.[14]付葵,杨镭镭,孙平.右美托咪定复合丙泊酚和瑞芬太尼靶控输注对老年脑功能区手术患者术中唤醒试验质量的影响[J].中国老年学杂志,2018,38(7):1636-1638.[15]李小刚,王强,温健,等.小剂量右美托咪定对脑功能区胶质瘤切除术患者术中唤醒的影响[J].广西医科大学学报,2019,36(8):1254-1259.[16]刘婷,廖兴志,吴文华,等.右美托咪定联合丙泊酚麻醉对脑外科手术患者血流动力学及炎性因子水平的影响[J].湖南师范大学学报(医学版),2018,15(2):94-97.[17]武辉,薛荣亮,李雪丹,等.右美托咪定对颅内肿瘤切除患者血流动力学的影响及脑保护效应研究[J].海南医学,2022,33(7):849-853.[18]王瑜,王天龙,李丽.右美托咪定对幕上脑肿瘤切除术气管插管时血流动力学的影响[J].北京医学,2018,40(9):858-860.[19]张杰,高杰,方茜,等.右美托咪定联合丙泊酚或依托咪酯对开颅手术老年患者围插管期血流动力学的影响[J].实用医学杂志,2018,34(16):2754-2757.[20]张元会,李晓龙.异丙酚与右美托咪定在脑胶质瘤切除术中的脑保护效应对比[J].实用癌症杂志,2019,34(6):923-925.

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更新日期/Last Update: 1900-01-01