右美托咪定对老年冠心病患者围手术期心脏不良事件的影响

发布时间：2018-04-12 09:06

本文选题：右美托咪定 + 老年　；参考：《中南大学学报(医学版)》2017年05期

【摘要】：目的:观察右美托咪定对冠心病患者围手术期心脏不良事件的影响。方法:择期行开腹胃癌切除术的老年冠心病患者60例,采用随机数字表法将其分为右美托咪定组(Dex组)与对照组(Control组),每组30例。两组患者麻醉管理一致,其中Dex组诱导麻醉前10 min静脉微量泵入右美托咪定0.5μg/kg,10 min后继续泵注维持量0.5μg/(kg·h)至手术结束;Control组在同一时点采用等量的生理盐水静脉输注。分别于术前、术毕、术后24 h采集静脉血标本,测定肌钙蛋白I(c Tn I)、N-末端脑利钠肽原(N-terminal pro-brain natriuretic peptide,NT-pro BNP)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的水平。记录术中、术后3 d心脏不良事件的发生情况。结果:两组患者术前血清c Tn I,NTpro BNP,hs-CRP水平比较,差异无统计学意义(P0.05);术后24 h时血清c Tn I,NT-pro BNP,hs-CRP较术前都显著升高(P0.05),且Dex组在术后24 h时血清c Tn I,NT-pro BNP及hs-CRP水平明显低于Control组(P0.05)。两组患者术中均未发生心肌梗死;与Control组比较,Dex组心动过缓发生率升高,心动过速和心肌缺血发生率降低(P0.05)。Dex组术后无症状性心肌缺血和心律失常发生率与Control组相比明显降低(P0.05)。结论:右美托咪定能够降低老年冠心病患者围手术期心脏不良事件的发生率。
[Abstract]:Objective: to observe the effect of dexmetomidine on adverse cardiac events in patients with coronary heart disease.Methods: sixty elderly patients with coronary heart disease undergoing open gastric cancer resection were randomly divided into dexmetomidine group (n = 30) and control group (n = 30).The anesthesia management of the two groups was the same. The Dex group received intravenous infusion of dexmetomidine 0.5 渭 g / kg for 10 min before induction anesthesia, and the maintenance volume was 0.5 渭 g/(kg / h after the operation. The same amount of saline was given to the Dex group at the same time point.Venous blood samples were collected before, at the end of operation and 24 hours after operation. The levels of N-terminal pro-brain natriuretic peptide N-terminal pro-brain natriuretic peptide NT-pro BNPP, hypersensitive C-reactive protein hs-CRP were measured.Adverse cardiac events were recorded 3 days after operation.Compared with the Control group, the incidence of bradycardia increased and the incidence of tachycardia and myocardial ischemia decreased in the two groups. The incidence of asymptomatic myocardial ischemia and arrhythmia in the Dex group was significantly lower than that in the Control group.Conclusion: dexmetomidine can reduce the incidence of perioperative adverse cardiac events in elderly patients with coronary heart disease.
【作者单位】：河北医科大学第四医院麻醉科;即墨市人民医院麻醉科;首都儿科研究所附属儿童医院麻醉科;
【分类号】：R614

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