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目的探讨右美托咪定对脑膜瘤手术患者的脑保护作用。方法将60例择期行脑膜瘤根治术的患者均分为两组。全身麻醉诱导前,D组10min内静脉泵入右美托咪定1μg/kg,继以24~40μg/h持续泵注,手术结束前30min停药;C组给予等容量生理盐水作为对照。记录术中MAP和HR变化;检测术前及术后1、6和12h血清TNF-α和IL-6水平;计算呼吸恢复时间、唤醒时间、拔管时间和术后躁动发生率。结果与麻醉前和D组相比,C组插管即刻和插管后5min的MAP升高,HR增快(P<0.01)。C组术后1和6h血清TNF-α和IL-6水平较术前和D组升高(P<0.01)。与C组相比,D组呼吸恢复时间、唤醒时间、拔管时间缩短,术后躁动发生率降低(P<0.01)。结论辅用右美托咪定能维持脑膜瘤手术患者术中循环稳定,减轻炎症反应,具有脑保护作用。
Objective To investigate the protective effect of dexmedetomidine on patients with meningioma surgery. Methods Sixty patients undergoing radical resection of meningiomas were divided into two groups. Before the induction of general anesthesia, group D was intravenously injected with dexmedetomidine 1μg / kg intravenously within 10 minutes, followed by continuous infusion of 24-40μg / h, and the drug was stopped 30 minutes before the end of surgery. C group was given normal saline as control. The changes of MAP and HR during operation were recorded. The levels of TNF-α and IL-6 in serum were measured before operation and at 1, 6 and 12 hours after operation. Respiratory recovery time, wake-up time, extubation time and incidence of postoperative agitation were calculated. Results Compared with pre-anesthesia group and D group, the MAP in group C immediately after intubation and at 5 min after intubation was higher than that in group D (P <0.01). The levels of serum TNF-α and IL-6 in group C at 1 and 6 h after operation were significantly higher than those before operation and those in group D (P <0.01). Compared with group C, respiration recovery time, wake time, extubation time and postoperative agitation rate in group D were decreased (P <0.01). Conclusions Supplementation with dexmedetomidine can maintain the intraoperative circulation stability and reduce the inflammatory reaction in patients with meningiomas, and has a protective effect on the brain.