文章摘要
金成浩,王 卫,赵美一,刘 强,王庚芸.不同剂量右美托咪定辅助脑梗死介入术治疗患者效果及对血流动力学及疼痛水平的影响[J].,2024,(2):247-252
不同剂量右美托咪定辅助脑梗死介入术治疗患者效果及对血流动力学及疼痛水平的影响
Effect of Different Doses of Dexmedetomidine on Hemodynamics and Pain Level in Patients with Cerebral Infarction Undergoing Interventional Therapy
投稿时间:2023-08-06  修订日期:2023-08-28
DOI:10.13241/j.cnki.pmb.2024.02.008
中文关键词: 不同剂量  右美托咪定  介入治疗  麻醉效果  血流动力学  疼痛
英文关键词: Different doses  Dexmedetomidine  Interventional therapy  Anesthetic effect  Hemodynamics  Pain
基金项目:国家自然科学基金项目(81301131)
作者单位E-mail
金成浩 首都医科大学附属北京同仁医院麻醉科 北京 100005 jch1371890@163.com 
王 卫 首都医科大学附属北京同仁医院神经外科 北京 100005  
赵美一 首都医科大学附属北京同仁医院麻醉科 北京 100005  
刘 强 首都医科大学附属北京同仁医院麻醉科 北京 100005  
王庚芸 首都医科大学附属北京同仁医院麻醉科 北京 100005  
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中文摘要:
      摘要 目的:分析不同剂量右美托咪定辅助脑梗死介入术治疗患者效果及对血流动力学及疼痛水平的影响。方法:选取2019年6月~2022年12月在本院行介入手术的90例脑梗死患者进行研究,将术中辅助应用生理盐水的30例患者纳入对照组,将辅助应用0.2 μg?kg-1右美托咪定的30例患者纳入低剂量组,应用0.6 μg?kg-1右美托咪定的30例患者纳入高剂量组。记录三组患者的呼吸恢复时间、定向力恢复时间、拔管时间及不良反应发生率,并在入室时(T0)、手术开始30 min(T1)、术毕(T3)和术后12 h(T4)检测三组患者的血流动力学[平均动脉压(MAP)、舒张压(DBP)、收缩压(SBP)、心率(HR)]和疼痛因子[血清P物质(SP)、5-羟色胺(5-HT)]水平。结果:三组呼吸恢复时间、定向力恢复时间、拔管时间比较,差异无统计学意义(P>0.05)。与对照组比较,低剂量组和高剂量组T1、T2时间段的MAP、HR、SBP、DBP水平较低;与低剂量组比较,高剂量组T1、T2时间段的MAP、HR、SBP、DBP水平较低(P<0.05)。与对照组比较,低剂量组和高剂量组T1、T2、T3时间段的SP、5-HT水平较低;与低剂量组比较,高剂量组T1、T2、T3时间段的SP、5-HT水平较低(P<0.05)。三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:高、低剂量右美托咪定均能帮助脑梗死介入治疗患者稳定血流动力学,还能减轻其疼痛感,而高剂量右美托咪定效果更为明显。
英文摘要:
      ABSTRACT Objective: The effects of different doses of dexmedetomidine on hemodynamics and pain level in patients with cerebral infarction were analyzed. Methods: A total of 90 patients with cerebral infarction who underwent interventional surgery in our hospital from June 2019 to December 2022 were selected for the study, and 30 patients with intraoperative adjuvant use of normal saline were included in the control group, and 30 patients with adjuvant use of 0.2 μg?kg-1 dexmedetomidine were included in the low-dose group. Thirty patients receiving 0.6 μg?kg-1 dexmedetomidine were included in the high-dose group. Respiratory recovery time, orientation recovery time, extubation time and incidence of adverse reactions were recorded in the three groups. The hemodynamics [mean arterial pressure (MAP), diastolic pressure (DBP), systolic blood pressure (SBP), heart rate (HR)] and pain factors [serum Substance P (SP), 5-hydroxytryptamine (5-HT)] of the three groups were measured at the time of entry (T0), 30 minutes after surgery (T1), after surgery (T3), and 12 hours after surgery (T4). Results: There was no significant difference in respiratory recovery time, orientation recovery time and extubation time among the three groups (P>0.05). Compared with the control group, the levels of MAP, HR, SBP and DBP in the low-dose and high-dose groups at T1 and T2 were lower. Compared with the low-dose group, the levels of MAP, HR, SBP and DBP in the high-dose group at T1 and T2 were lower (P<0.05). Compared with the control group, the levels of SP and 5-HT in T1, T2 and T3 periods were lower in low-dose and high-dose groups. Compared with low-dose group, the levels of SP and 5-HT in T1, T2 and T3 periods in high-dose group were lower (P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion: Both high-dose and low-dose dexmedetomidine can help stabilize hemodynamics and relieve pain in patients with cerebral infarction undergoing interventional therapy, and the effect of high-dose dexmedetomidine is more obvious.
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