| 吴 婷,葛志军,朱敏敏,谢松辉,汤为光,杨志龙.不同剂量右美托咪定静脉维持对重型颅脑损伤患者术后生命体征、免疫功能和血清神经细胞因子的影响[J].,2022,(6):1131-1136 |
| 不同剂量右美托咪定静脉维持对重型颅脑损伤患者术后生命体征、免疫功能和血清神经细胞因子的影响 |
| Effects of Different Doses of Dexmedetomidine on Postoperative Vital Signs, Immune Function and Serum Neurocytokines in Patients with Severe Craniocerebral Injury |
| 投稿时间：2021-08-21 修订日期：2021-09-16 |
| DOI：10.13241/j.cnki.pmb.2022.06.028 |
| 中文关键词: 右美托咪定 静脉维持 重型颅脑损伤 术后生命体征 免疫功能 血清神经细胞因子 |
| 英文关键词: Dexmedetomidine Venous maintenance Severe craniocerebral injury Postoperative vital signs Immune function Serum neurocytokines |
| 基金项目:国家自然科学基金青年基金项目（81802102） |
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| 中文摘要: |
| 摘要 目的：观察不同剂量右美托咪定静脉维持在重型颅脑损伤患者中的应用价值。方法：选取2018年9月~2020年9月期间江苏大学附属宜兴市人民医院麻醉与重症医学科接收的重型颅脑损伤患者96例，根据随机数字表法分为三组：A组（右美托咪定剂量为0.3μg/kg?h）、B组（右美托咪定剂量为0.5 μg/kg?h）和C组（右美托咪定剂量为0.7 μg/kg?h），各32例。观察三组患者不同时间点的生命体征、免疫功能、镇静镇痛情况、血清神经细胞因子，记录三组不良反应发生情况。结果：B组、C组术后24 h、术后72 h的心率（HR）、呼吸频率（RR）、平均动脉压（MAP）低于A组（P<0.05）。B组、C组术后24 h、术后72 h的Ramsay镇静评分、视觉模拟评分法（VAS）评分低于A组（P<0.05）。B组、C组术后24 h、术后72 h的CD3+、CD4+/CD8+高于A组（P<0.05）。B组、C组术后24 h、术后72 h的神经元特异性烯醇化酶（NSE）、中枢神经特异性蛋白（S100β）低于A组（P<0.05）。C组的不良反应总发生率高于A组、B组（P<0.05）。结论：重型颅脑损伤患者术中给予右美托咪定剂量为0.5 μg/kg?h、0.7 μg/kg?h维持，可有效维持患者生命体征平稳，促进患者免疫功能和血清神经细胞因子水平改善，但0.7 μg/kg?h剂量的右美托咪定使用后不良反应发生率相对更高。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the application value of intravenous maintenance of dexmedetomidine in patients with severe craniocerebral injury. Methods: 96 patients with severe craniocerebral injury who were accepted by the anesthesiology and critical medicine department of Yixing people's hospital affiliated to Jiangsu university from September 2018 to September 2020 were selected, and they were randomly divided into three groups according to random number table method: group A (dose of dexmedetomidine was 0.3 μg/kg?h), group B (dexmedetomidine dose was 0.5 μg/kg?h) and group C (dexmedetomidine dose was 0.7 μg/kg?h), 32 cases in each group. The vital signs, immune function, sedation and analgesia, serum neurocytokines in the three groups at different time points were observed. The incidence of adverse reactions in three groups was recorded. Results: The heart rate (HR), respiratory rate (RR) and mean arterial pressure (MAP) in group B and group C were lower than those in group A (P<0.05). Ramsay sedation score and visual analogue scale of pain (VAS) scores in group B and group C at 24 h after operation and 72 h after operation were lower than those in group A(P<0.05). The CD3+, CD4+/CD8+ in group B and group C at 24 h after operation and 72 h after operation were higher than those in group A (P<0.05). Neuron specific enolase (NSE), central nerve specific protein (S100β) in group B and group C at 24 h after operation and 72 h after operation were lower than those in group A(P<0.05). The total incidence of adverse reactions in group C was higher than that in group A and group B(P<0.05). Conclusion: Patients with severe craniocerebral injury are given dexmedetomidine at a dose of 0.5 μg/kg?h, 0.7 μg/kg?h maintenance can effectively maintain the stability of vital signs, and promote the improvement of immune function and serum neurocytokine level, but the incidence of adverse reactions after dexmedetomidine at 0.7 μg/kg?h is relatively higher. |
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