| 刘 辉,闽红星,王惠娟,顾顺强,王海江,张建峰,祁亚宁.右美托咪定联合七氟醚麻醉对下肢骨折患者血流动力学、应激反应的影响及心肌保护作用研究[J].,2021,(10):1946-1950 |
| 右美托咪定联合七氟醚麻醉对下肢骨折患者血流动力学、应激反应的影响及心肌保护作用研究 |
| Study of Influences of Dexmedetomidine Combined with Sevoflurane Anesthesia on Hemodynamics, Stress Response and Its Myocardial Protective Effects in Patients with Lower Limb Fracture |
| 投稿时间：2020-09-23 修订日期：2020-10-18 |
| DOI：10.13241/j.cnki.pmb.2021.10.031 |
| 中文关键词: 右美托咪定 七氟醚 下肢骨折 血流动力学 应激反应 心肌保护 |
| 英文关键词: Dexmedetomidine Sevoflurane Lower limb fracture Hemodynamics Stress response Myocardial protection |
| 基金项目:宁夏回族自治区科学技术厅项目(2016KJHM57) |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定联合七氟醚麻醉对下肢骨折患者应激反应、血流动力学的影响及心肌保护作用研究。方法：选取下肢骨折患者116例，分为对照组（n=58）和观察组（n=58），对照组给予右美托咪定联合丙泊酚麻醉，观察组给予右美托咪定联合七氟醚麻醉，对比两组血流动力学指标、应激反应指标、心肌指标、术后疼痛及不良反应。结果：观察组拔管时（T2）~拔管10 min后（T4）时间点心率（HR）、平均动脉压（MAP）低于对照组（P<0.05）。两组不良反应发生率比较无差异（P>0.05）。两组术后1 d皮质醇（Cor）、肾上腺素（E）均较术前升高，但观察组低于对照组（P<0.05）。观察组术后1 d肌酸激酶（CK）、乳酸脱氢酶（LDH）、心肌肌钙蛋白（cTnI）低于对照组（P<0.05）。观察组术后6 h、术后 12 h、术后 24 h视觉模拟评分法（VAS）评分均低于对照组（P<0.05）。结论：右美托咪定联合七氟醚麻醉可稳定下肢骨折患者血流动力学，减轻机体应激反应及术后疼痛，同时还可发挥一定的心肌保护作用。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the study of influences of dexmedetomidine combined with sevoflurane anesthesia on stress response, hemodynamics and its myocardial protective effects in patients with lower limb fracture. Methods: 116 patients with lower limb fracture were selected. They were divided into control group (n=58) and observation group (n=58) according to the random stratified sampling method, the control group was given dexmedetomidine combined with propofol during anesthesia, the observation group was given dexmedetomidine combined with sevoflurane during anesthesia, hemodynamic indexes, stress response indexes, myocardial indexes, postoperative pain and adverse reactions were compared between the two groups. Results: The heart rate (HR), mean arterial pressure (MAP) of the observation group were lower than those of the control group on the time point of during extubating (T2) ~ 10min after extubation（T4）(P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). The cortisol (Cor), epinephrine (E) of the two groups were higher than those of before operation 1d after operation, but the observation group was lower than that of the control group (P<0.05). The creatine kinase (CK), lactate dehydrogenase (LDH), cardiac troponin (cTnI) in the observation group were lower than those of the control group 1d after operation (P<0.05). The visual analogue scale (VAS) scores of the observation group were all lower than those of the control group 6 h after operation, 12 h after operation, 24 h after operation (P<0.05). Conclusion: Dexmedetomidine combined with sevoflurane anesthesia can stabilize the hemodynamics of patients with lower limb fracture, reduce the body stress response and postoperative pain, which can also play a certain role in myocardial protection at the same time. |
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