| 肖 荣,来 伟,鲁利峰,丁国友,孟海兵.不同浓度的右美托咪定对老年腰椎术患者的镇静效果、氧化应激和血流动力学的影响[J].,2018,(22):4312-4316 |
| 不同浓度的右美托咪定对老年腰椎术患者的镇静效果、氧化应激和血流动力学的影响 |
| Effects of Different Concentrations of Dexmedetomidine on Sedation,Oxidative Stress and Hemodynamics in Elderly Patients Undergoing Lumbar Surgery |
| 投稿时间：2018-07-01 修订日期：2018-07-25 |
| DOI：10.13241/j.cnki.pmb.2018.22.025 |
| 中文关键词: 右美托咪定 老年 腰椎术 镇静效果 氧化应激 血流动力学 |
| 英文关键词: Dexmedetomidine Elderly Lumbar surgery Sedation effect Oxidative stress Hemodynamics |
| 基金项目:江西省卫生计生委科技计划项目（20132683） |
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| 中文摘要: |
| 摘要 目的：探讨不同浓度的右美托咪定对老年腰椎术患者的镇静效果、氧化应激和血流动力学的影响。方法：选取2013年3月-2018年4月期间我院收治的老年腰椎术患者90例为研究对象。根据随机数字表法将患者分为对照组（n=30）、低浓度组（n=30）以及高浓度组（n=30）。低浓度组麻醉诱导前输注0.5 μg/kg右美托咪定，高浓度组输注1 μg/kg右美托咪定，对照组不输注右美托咪定。比较给药前（T0）、给药后10 min（T1）、给药后30 min（T2）、给药后60 min（T3）的听觉诱发电位指数（AAI）、改良/镇静视觉评分（OAA/S）。比较T0、T3、手术后24h（T4）的三组患者丙二醛（MDA）、超氧化物歧化酶（SOD）水平。比较T0-T3时间点三组患者的心率（HR）、平均动脉压（MAP）情况。观察三组患者术后不良反应发生情况。结果：与T0时间点比较，三组T1-T3时间点AAI、OAA/S均显著降低（P<0.05）；与对照组相比，低浓度组与高浓度组T1-T3时间点AAI、OAA/S均较低，且高浓度组低于低浓度组（P<0.05）。与T0时间点比较，三组T3、T4时间点MDA均显著升高，T3时间点SOD显著降低（P<0.05）；与对照组相比，低浓度组与高浓度组T3、T4时间点MDA均降低，且高浓度组低于低浓度组（P<0.05）；高浓度组T3、T4时间点SOD高于低浓度组和对照组（P<0.05）。与T0时间点比较，三组T2、T3时间点HR、MAP均降低（P<0.05）；与对照组相比，低浓度组、高浓度组T2、T3时间点HR均降低，且高浓度组低于低浓度组（P<0.05）；与对照组相比，低浓度组、高浓度组T2、T3时间点MAP均降低，但高浓度组高于低浓度组（P<0.05）。三组患者术后不良反应总发生率比较差异无统计学意义（P>0.05）。结论：1μg/kg右美托咪定对老年腰椎术患者的镇静效果较好，可有效维持血流动力学稳定，减轻氧化应激反应。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of different concentrations of dexmedetomidine on sedation, oxidative stress and hemodynamics in elderly patients undergoing lumbar surgery. Methods: 90 cases of elderly lumbar spine surgery in our hospital from March 2013 to April 2018 were selected as research subjects. According to the number table method, the patients were randomly divided into control group (n=30), low concentration group (n=30) and high concentration group (n=30). The control group did not receive dexmedetomidine, the low concentration group was given 0.5 μg/kg dexmedetomidine, and the high concentration group was given 1 μg/kg dexmedetomidine. The auditory evoked potential index (AAI), modified / sedative visual score (OAA/S) before administration (T0), 10 min after administration (T1), 30 min after administration (T2), 60 min after administration (T3), and 60 min after administration (T3) were compared. malondialdehyde (MDA) and superoxide dismutase (SOD) were compared between T0, T3 and 24h after operation (T4). The heart rate (HR) and mean arterial pressure (MAP) of T0-T3 time points were compared. The incidence of postoperative ADR in the two groups were observed. Results: Compared with T0 time point, AAI and OAA/S at T1-T3 time points in the three groups were significantly reduced (P<0.05), compared with the control group, AAI, OAA/S at T1-T3 time points in low concentration group and high concentration group were lower, while the high concentration group were lower than that in low concentration group(P<0.05). Compared with the T0 time point, the three groups of T3 and T4 time points MDA increased significantly, SOD at T3 time point significantly decreased (P<0.05). Compared with the control group, the T3 and T4 time point MDA in the low concentration group and the high concentration group decreased, and the high concentration group was lower than that of the low concentration group (P<0.05), and SOD of T3 and T4 in the high concentration group was higher than that of the low concentration group and the control group (P<0.05). Compared with the time point of T0, the three groups of T2 and T3 time points HR and MAP decreased (P<0.05). Compared with the control group, HR at the T2 and T3 time points in the low concentration group and the high concentration group decreased, and the high concentration group was lower than the low concentration group (P<0.05). Compared with the control group, the T2 and T3 time points of MAP in low concentration group and high concentration group decreased, but the high concentration group were higher than those in low concentration group (P<0.05). There was no significant difference in the incidence of adverse reactions between the three groups (P>0.05). Conclusion: 1 μg/kg dexmedetomidine has better sedative effect in elderly patients undergoing lumbar surgery, which can effectively maintain hemodynamic stability and relieve oxidative stress. Dative stress and do not increase postoperative adverse reactions. It has certain clinical value. |
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