不同剂量右美托咪啶对60岁以上髋部手术患者的脑保护效应

发布时间：2018-03-02 23:08

本文选题：髋部手术　切入点：右美托咪啶　出处：《实用医学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:探讨不同剂量右美托咪啶(Dex)对60岁以上髋关节置换手术患者的脑保护效应。方法:将80例60岁以上择期在椎管内麻醉下行髋关节置换手术患者随机分为4组:D0组为不用Dex对照组,D1、D2和D3组分别于椎管内麻醉后按0.5、0.75和1.0μg/(kg·h)静脉输注Dex,并于术前、术中及术毕时抽血检测TNF-α、IL-10、NSE、S100b,以及进行蒙特利尔认知功能评估。结果:4组患者的IL-10水平在术中及术毕时逐渐升高,其中D3组的增高比其他3组显著,4组组间比较具有统计学差异(P0.05)。各组患者的血浆NSE和S100β水平在术中及术后时均较术前逐渐升高,其中D0组的增高较D2和D3组更为显著(P0.05)。D3组于术后第1、7天的Mo CA评分最高,4组组间比较差异具有统计学意义(P0.05)。结论:60岁以上患者椎管内麻醉髋关节置换手术中静脉输注Dex具有一定的脑保护作用,其中以1.0μg/(kg·h)静脉输注的作用更为明显。
[Abstract]:Objective: to investigate the brain protective effects of dexmetidine Dexen at different doses on patients over 60 years of age undergoing hip arthroplasty. Methods: 80 patients over 60 years of age were randomly divided into 4 groups under intraspinal anesthesia. Group 1: D0: no Dex control group D _ 1D _ 2 and D _ 3 were injected intravenously with 0.5 渭 g / kg / kg and 1.0 渭 g / kg / h respectively after intraspinal anesthesia, and before operation, TNF- 伪 IL-10 NSES100b was measured during and at the end of operation, and the cognitive function of Montreal was evaluated. Results the level of IL-10 increased gradually during operation and at the end of operation in the 4 groups. The levels of plasma NSE and S100 尾 in D3 group were significantly higher than those in the other three groups (P 0.05). The levels of plasma NSE and S100 尾 in each group were increased gradually during and after operation. The increase in D0 group was significantly higher than that in D2 and D3 groups (P 0.05N. D3). The highest Mo CA score in group D 3 was significantly higher than that in group D 2 and group D 3 on the 1st day after operation (P 0.05). Conclusion there is a significant difference between group D 0 and group D 3 in intrathecal anesthesia of hip replacement in patients over 60 years of age. Infusion of Dex has a protective effect on brain. Intravenous infusion of 1.0 渭 g / kg 路h was more effective.
【作者单位】：广州中医药大学第二附属医院麻醉科;解放军四五八医院妇产科;广州中医药大学第二临床医学院;
【分类号】：R614

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