摘要
目的观察右美托咪定对脑胶质瘤切除术患者脑氧摄取率(CERO2)及脑脊液氨基酸的影响.方法选取脑胶质瘤切除术患者60例,以随机单盲法分为试验组、对照组,各30例.全麻基础上,试验组予以右美托咪定,对照组予以等量生理盐水.对比2组麻醉前(T0)、气管插管时(T1)、开颅时(T2)、术毕时(T3)的血流动力学(心率、平均动脉压)、CERO2及术前、术后6h、术后24 h的脑脊液氨基酸[抑制性氨基酸γ-氨基丁酸(GABA)、兴奋性氨基酸天门冬氨酸(Asp)、谷氨酸(Glu)]水平.结果试验组T1、T2时心率、平均动脉压水平较T0时降低,且低于对照组(P<0.05);试验组T1、T2、T3时CERO2水平较T0时升高,且高于对照组(P<0.05);试验组术后6h、术后24 h的脑脊液GABA水平高于对照组,Asp、Glu水平低于对照组(P<0.05).结论右美托咪定应用于脑胶质瘤切除术患者可升高CERO2,维持血流动力学平稳,改善脑脊液氨基酸表达,起到脑保护作用.
Objective To observe the effects of dexmedetomidine on cerebral extraction ratio for oxygen(CERO2)and cerebrospinal fluid(CSF)amino acids in patients who underwent a glioma resection.Methods A total of 60 patients who underwent a glioma resection were enrolled and divided into test group and control group using the single-blind random method,with 30 cases in each group.After general anesthesia,the test group was given dexmedetomidine,and the control group was given an equivalent amount of normal saline.The two groups were compared for hemodynamic indices(heart rate and mean arterial pressure)and CERO2 before anesthesia(T0),during tracheal intubation(T1),during craniotomy(T2),and at the end of operation(T3)as well as levels of CSF amino acids(inhibitory amino acidγ-aminobutyric acid[GABA]and excitatory amino acids aspartic acid[Asp]and glutamic acid[Glu])before operation and at 6 h and 24 h after operation.Results The heart rate and mean arterial pressure in the test group at T1 and T2 were significantly lower than those at T0,and they were also significantly lower than those in the control group(P<0.05).The CERO2 levels in the test group at T1,T2,and T3 were significantly higher than those at T0,and they were also significantly higher than those in the control group(P<0.05).The test group had a significantly higher level of GABA and significantly lower levels of Asp and Glu in the CSF than the control group at 6 h and 24 h after operation(P<0.05).Conclusions Dexmedetomidine can increase CERO2,maintain hemodynamic balance and stability,and improve CSF amino acid expression in patients who underwent a glioma resection,thus protecting the brain.
作者
李洪影
庞红利
毛姗姗
孙习文
LI Hong-Ying;PANG Hong-Li;MAO Shan-Shan;SUN Xi-Wen(Department of Anesthesia,The First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《国际神经病学神经外科学杂志》
2019年第5期495-499,共5页
Journal of International Neurology and Neurosurgery
基金
开封市科技发展计划项目(1803037、1603082、1803012)
