| 常洪玲,张 建,江 浩,杨 恺,孙千卉.不同的麻醉方案对脑幕上肿瘤手术患者麻醉苏醒期血流动力学的影响[J].,2020,(22):4392-4395 |
| 不同的麻醉方案对脑幕上肿瘤手术患者麻醉苏醒期血流动力学的影响 |
| Effects of Different Anesthesia Schemes on the Hemodynamics of Patients Undergoing Supratentorial Tumor Surgery |
| 投稿时间：2020-04-03 修订日期：2020-04-27 |
| DOI：10.13241/j.cnki.pmb.2020.22.043 |
| 中文关键词: 脑幕上肿瘤手术 右美托咪定 异氟醚 苏醒 血流动力学 麻醉效果 脑氧代谢 |
| 英文关键词: Supratentorial tumor surgery Dexmedetomidine Isoflurane Recovery Hemodynamics Anesthesia effect Cerebral oxygen metabolism |
| 基金项目:国家自然科学基金项目(81612740) |
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| 中文摘要: |
| 摘要 目的：对比不同麻醉方案对脑幕上肿瘤手术患者麻醉苏醒期血流动力学的影响。方法：选取2017年10月至2019年10月于我院择期行脑幕上肿瘤手术患者为本次研究对象，将其随机分为研究组(n=40)和对照组(n=40)。对照组术中接受右美托咪定麻醉，研究组术中接受异氟醚麻醉，观察并对比研究组和对照组在麻醉诱导前(T0)、麻醉后30 min(T1)、麻醉后1 h(T2)以及手术结束时(T3)血流动力学指标[心率(Heart rate，HR)，平均动脉压(Mean arterial pressure，MAP)]、脑氧代谢情况[颈内静脉球部血氧饱和度(Oxygen saturation of the bulb of internal jugular vein，SjvO2), 动脉血氧含量(Arterial oxygen content，CaO2)，脑静脉氧含量(Cerebral jugular venous oxygen content，CjvO2)，脑氧摄取率(Cerebralextractionofoxygen，CERO2)]，并分析研究组和对照组麻醉效果(优、良、差)和手术相关指标(手术时间、麻醉时间、苏醒时间、输液量)情况。结果：与T0时相比，研究组和对照组在T1~T2时MAP和HR均降低，且对照组明显低于研究组(P<0.05)；与T0时相比，T3时研究组MAP和HR均增加(P＜0.05)；与T0、T1、T3时相比，研究组和对照组T2时MAP和HR均较低，对照组低于研究组(P<0.05)；与T0时相比，研究组和对照组在T1~T3时CjvO2明显增高，CERO2明显降低，研究组在T1~T3时CjvO2高于对照组，研究组在T1~T3时CERO2低于对照组(P<0.05)，在T0~T3时研究组和对照组SjvO2、CaO2差异不明显(P＞0.05)；与对照组相比，研究组患者麻醉效果优良率较高(P<0.05)，苏醒时间明显缩短(P<0.05)，研究组和对照组手术时间、麻醉时间、输液量差异不明显(P＞0.05)。结论：：右美托咪定用于脑幕上肿瘤手术患者麻醉效果较好，可以有效稳定血流动力学，降低脑氧代谢，缩短苏醒时间。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of different anesthesia schemes on hemodynamics of patients undergoing supratentorial tumor surgery. Methods: Patients who underwent supratentorial tumor surgery in our hospital from October 2017 to October 2019 were randomly divided into study group (n=40) and control group (n=40). The patients in the control group were anesthetized with dexmedetomidine and the patients in the study group were anesthetized with isoflurane. Before anesthesia induction (T0), 30 minutes after anesthesia (T1), 1 hour after anesthesia (T2) and at the end of operation (T3), hemodynamic indexes (heart rate (HR), mean arterial pressure (MAP) and cerebral oxygen metabolism (SjvO2) were observed and compared between two groups, the arterial oxygen content (CaO2), cerebral venous oxygen content (CjvO2), cerebral oxygen uptake rate (CERO2)], and the anesthesia effect (excellent, good, bad) and operation related indexes (operation time, anesthesia time, recovery time, infusion volume) of both groups were analyzed. Results: Compared with T0, the MAP and HR of both groups decreased from T1 to T2, which were significantly lower in the control group than those in the study group (P<0.05); compared with T0, the MAP and HR of both groups increased from T3 (P<0.05); compared with T0, T1, T3, the MAP and HR of both groups were lower at T2, and the MAP and HR of control group were lower than those in study group (P<0.05); compared with T0, the CjvO2 of the study group and the control group increased significantly at T1 to T3. The CjvO2 at T1, T2 and T3 in the study group were higher than those in the control group (P<0.05), while the CERO2 were lower than those in the control group (P<0.05), and there was no significant difference in the between the SjvO2 and CaO2 between from T0 to T3 two groups (P>0.05); compared with the control group, the excellent rate of anesthesia effect in the study group was higher (P<0.05), the recovery timewas significantly shorter (P<0.05). There was no significant difference in operation time, anesthesia time and infusion volume between two groups (P>0.05). Conclusion: Dexmedetomidine has a good anesthetic effect on patients undergoing supratentorial tumor surgery. It can effectively stabilize the hemodynamics, reduce the cerebral oxygen metabolism, and shorten the recovery time. |
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