杨雪;栗付民;韩灵龙;

• 1:许昌市中心医院

摘要(Abstract)：

目的探讨右美托咪定与利多卡因对颅脑损伤手术患者术后炎性应激反应、脑损伤的影响。方法选取2018-03—2020-05许昌市中心医院颅脑损伤手术患者102例,以简单随机化法分为观察组(n=51)、对照组(n=51)。对照组在麻醉诱导前予以1.5 mg/kg利多卡因,术中应用2 mg/(kg·h)速度静脉维持到术毕,观察组在对照组基础上麻醉诱导前予以0.6μg/kg右美托咪定输注15 min,而后以0.2μg/(kg·h)速度维持到术毕。对比2组不良反应、术后1周认知功能障碍发生情况与麻醉诱导前(T0)、插管后即刻(T1)、开颅时(T2)、术毕拔管时(T3)血流动力学指标[平均动脉压(MAP)、心率(HR)]水平,T0、T3、术后12 h(T4)、术后24 h(T5)血清炎症因子指标[肿瘤坏死因子-α(TNF-α)、超敏-C反应蛋白(hsCRP)、白细胞介素-6(IL-6)]、应激反应指标[血糖(GLU)、肾上腺素(E)、皮质醇(Cor)]、脑损伤指标[神经元特异性烯醇化酶(NSE)、S-100β蛋白]水平,T0、术后3 d、术后1周认知功能评分(MMSE)。结果观察组T1、T2、T3时MAP、HR水平低于对照组(P<0.05)。2组T3、T4、T5时血清TNF-α、hs-CRP、IL-6、GLU、E、Cor、NSE、S-100β蛋白水平较T0时提高,但观察组低于对照组(P<0.05)。2组术后3 d、术后1周的MMSE评分较T0时降低,但观察组高于对照组(P<0.05)。2组不良反应发生率相比,差异无统计学意义(P>0.05)。观察组术后1周认知功能障碍发生率(5.88%)低于对照组(19.61%,P<0.05)。结论右美托咪定结合利多卡因应用于颅脑损伤手术患者可稳定术中血流动力学,减轻机体炎症应激反应与脑损伤、认知功能损害,且安全性良好。

关键词(KeyWords)： 颅脑损伤;血肿清除术;去骨瓣减压术;右美托咪定;利多卡因;炎性应激反应

Abstract:

Keywords:

基金项目(Foundation): 许昌市科技计划项目(编号：20190213187)

作者(Author): 杨雪;栗付民;韩灵龙;

Email:

DOI:

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