| 张 泽,周晓辉,郭琼梅,田长征,高巍巍.BIS监测下右美托咪定联合七氟醚对颅内动脉瘤介入栓塞术患者苏醒质量、血清氧化应激指标和神经损伤标志物的影响[J].,2023,(9):1716-1720 |
| BIS监测下右美托咪定联合七氟醚对颅内动脉瘤介入栓塞术患者苏醒质量、血清氧化应激指标和神经损伤标志物的影响 |
| Effects of Dexmedetomidine Combined with Sevoflurane under BIS Monitoring on the Quality of Awakening, Serum Oxidative Stress Indexes and Nerve Injury Markers in Patients Undergoing Interventional Embolization for Intracranial Aneurysms |
| 投稿时间：2022-09-27 修订日期：2022-10-22 |
| DOI：10.13241/j.cnki.pmb.2023.09.023 |
| 中文关键词: 右美托咪定 七氟醚 颅内动脉瘤 介入栓塞术 苏醒质量 氧化应激 神经损伤 |
| 英文关键词: Dexmedetomidine Sevoflurane Intracranial aneurysms Interventional embolization Quality of awakening Oxidative stress Nerve injury |
| 基金项目:河北省卫健委医学科学研究项目（20190442） |
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| 摘要 目的：探讨脑电双频指数（BIS）监测下右美托咪定联合七氟醚对颅内动脉瘤介入栓塞术患者苏醒质量、血清氧化应激指标和神经损伤标志物的影响。方法：采用随机数字表法，将我院2019年3月-2021年6月期间收治的80例颅内动脉瘤介入栓塞术患者分为研究组（BIS监测下右美托咪定联合七氟醚，n=40）和对照组（BIS监测下七氟醚，n=40），观察两组血流动力学、苏醒质量、血清氧化应激指标和神经损伤标志物水平变化。记录两组围术期间不良反应发生状况。结果：气管插管后1 min（T1）~拔管后10 min（T4）时点，两组平均动脉压（MAP）、心率（HR）升高后下降，但研究组低于对照组同时点（P<0.05）。与对照组比较，研究组苏醒时间、恢复呼吸时间、拔管时间较短（P<0.05）。T1~T4时点，两组超氧化物歧化酶（SOD）、过氧化氢酶（CAT）水平下降后升高，但研究组较对照组同时点高（P<0.05）。术后1 d，两组人脑髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）、S100?茁水平升高，但研究组低于对照组同时点（P<0.05）。对照组、研究组的不良反应发生率组间对比无显著性差异（P>0.05）。结论：BIS监测下七氟醚联合右美托咪定应用于颅内动脉瘤介入栓塞术患者中，可提高苏醒质量，减轻氧化应激水平和神经损伤程度，稳定血流动力学波动。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of dexmedetomidine combined with sevoflurane under bispectral index (BIS) monitoring on quality of awakening serum oxidative stress indexes and nerve injury markers in patients undergoing interventional embolization for intracranial aneurysms. Methods: Using the random number table method, 80 patients with interventional embolization for intracranial aneurysms who were admitted to our hospital from March 2019 to June 2021 were divided into the study group (dexmedetomidine combined with sevoflurane under BIS monitoring, n=40) and the control group (sevoflurane under BIS monitoring, n=40). The changes of hemodynamics, recovery quality, serum oxidative stress indexes and nerve injury markers in the two groups were observed. The occurrence of adverse reactions during perioperative period in the two groups was recorded. Results: From 1 min after endotracheal intubation (T1) to 10 min after extubation (T4), the mean arterial pressure (MAP) and heart rate (HR) in the two groups increased and then decreased, but the study group was lower than the control group at the same time (P<0.05). Compared with the control group, the awakening time, recovery breathing time and extubation time in the study group were shorter (P<0.05). At T1~T4, the levels of superoxide dismutase (SOD) and catalase (CAT) in the two groups decreased and then increased, but the study group was higher than the control group at the same time point (P<0.05). 1 d after operation, the levels of myelin basic protein (MBP), neuron-specific enolase (NSE) and S100β in the two groups were increased, but the study group was lower than the control group at the same time (P<0.05). There was no significant difference in the incidence of adverse reactions in the control group and the study group (P>0.05). Conclusion: Sevoflurane combined with dexmedetomidine under BIS monitoring can improve the quality of awakening, reduce the level of oxidative stress and the degree of nerve injury, and stabilize hemodynamic fluctuations in patients undergoing interventional embolization for intracranial aneurysms. |
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