| 李彩凤,高建新,崔 哲,易理生,袁星星.七氟醚联合右美托咪定对剖宫产分娩的子痫前期患者血流动力学、炎症反应和血清S100β、NSE的影响[J].,2022,(11):2138-2142 |
| 七氟醚联合右美托咪定对剖宫产分娩的子痫前期患者血流动力学、炎症反应和血清S100β、NSE的影响 |
| Effects of Sevoflurane Combined with Dexmedetomidine on Hemodynamics, Inflammatory Response and Serum S100β, NSE in Patients with Preeclampsia Delivered by Cesarean Section |
| 投稿时间：2022-01-07 修订日期：2022-01-30 |
| DOI：10.13241/j.cnki.pmb.2022.11.027 |
| 中文关键词: 七氟醚 右美托咪定 剖宫产 子痫前期 血流动力学 炎症反应 S100β NSE |
| 英文关键词: Sevoflurane Dexmedetomidine Cesarean section Preeclampsia Hemodynamics Inflammatory response S100β NSE |
| 基金项目:湖南省自然科学基金项目（2019JJ410010） |
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| 中文摘要: |
| 摘要 目的：观察七氟醚联合右美托咪定对剖宫产分娩的子痫前期患者血流动力学、炎症反应和血清S100β、神经元特异性烯醇化酶（NSE）的影响。方法：采用随机数字表法，将我院2019年8月~2021年5月期间收治的行剖宫产分娩的80例子痫前期患者分为对照组（n=40，七氟醚）和研究组（n=40，七氟醚联合右美托咪定）。对比两组血流动力学、炎症反应和血清S100β、NSE、镇静情况，记录两组麻醉期间不良反应发生情况。结果：给药前（T1）~拔管时（T4）时点，两组心率（HR）、平均动脉压（MAP）和血氧饱和度（SpO2）均下降后又升高（P<0.05），麻醉诱导后（T2）~胎儿娩出时（T3）时点，研究组HR、SpO2、MAP高于对照组（P<0.05）。T4~术后24 h（T6）时点，两组血清S100β、NSE水平升高后下降（P<0.05），T4~T6时点，研究组血清S100β、NSE水平低于对照组（P<0.05）。T6时点，研究组白介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平低于对照组（P<0.05）。研究组T3、T4时点Richmond评分低于对照组（P<0.05）。两组不良反应总发生率对比未见差异（P>0.05）。两组新生儿出生后1 min、5 min Apgar评分组间对比无统计学差异（P>0.05）。两组新生儿出生后5 min的Apgar评分较出生后1 min升高（P<0.05）。结论：七氟醚联合右美托咪定用于剖宫产分娩的子痫前期患者，可稳定血流波动，减轻炎症反应，同时还具有一定的脑保护作用。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of sevoflurane combined with dexmedetomidine on hemodynamics, inflammatory response and serum S100β, neuron specific enolase (NSE) in patients with preeclampsia delivered by cesarean section. Methods: Using random number table method, 80 cases of preeclampsia patients who underwent cesarean delivery in our hospital from August 2019 to May 2021 were divided into control group (n=40, sevoflurane) and study group (n=40, sevoflurane combined with dexmedetomidine). Hemodynamics, inflammatory response, serum S100β, NSE and sedation situation were compared between the two groups, and the incidence of adverse reactions during anesthesia in the two groups was recorded. Results: The heart rate (HR), mean arterial pressure (MAP) and blood oxygen saturation(SpO2) decreased and then increased in both groups from the time point before administration (T1) to extubation (T4) time points (P<0.05). The HR, SpO2 and MAP in the study group were higher than those in the control group after induction of anesthesia (T2) to delivery of the fetus (T3) time points (P<0.05). From T4 to 24 h (T6) after operation time points, the serum S100β and NSE levels in both groups increased and then decreased(P<0.05). From T4 to T6 time points, the serum S100β and NSE levels in the study group were lower than those in the control group(P<0.05). At T6 time points, the interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) levels in the study group were lower than those in the control group(P<0.05). Richmond score at T3 and T4 time points in the study group was lower than that in the control group (P<0.05). There was no difference in the total incidence of adverse reactions between the two groups (P>0.05). There was no significant difference in Apgar score between the two groups at 1 min and 5 min after birth(P>0.05). The Apgar score of newborns in the two groups at 5 min after birth was higher than that at 1 min after birth (P<0.05). Conclusion: Sevoflurane combined with dexmedetomidine in patients with preeclampsia delivered by cesarean section can stabilize blood flow fluctuation, reduce inflammatory reaction, and have a certain brain protective effect. |
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