CAJ | 학술논문

目的观察右美托咪啶( Dex)对非体外循环冠状动脉旁路移植术( OPCABG)患者围术期心肌损伤的保护作用。方法选择行OPCABG的患者60例( ASAII~Ⅲ级,心功能II~Ⅲ级),随机双盲分为Dex组(D组,输注Dex)和空白对照组(C组,输注0.9%的氯化钠溶液)各30例,分两个阶段给药,先以1μg/(kg·h)经微量注射泵静注给药15分钟,随后以0.5μg/(kg·h)维持给药至手术结束。分别于入室后( T0),血管吻合完毕( T1),术后6、12、24小时( T2、T3、T4)抽取中心静脉血,测定IMA和 cTnI。结果两组患者入室后IMA、cTnI比较差异无统计学意义(P>0.05),D组在血管吻合完毕,术后6、12小时IMA均显著低于C组(P<0.01),术后6、12、24小时cTnI均显著低于C组(P<0.05)。结论右美托咪啶能稳定血流动力学,减轻非体外循环冠状动脉旁路移植术患者围术期心肌损伤,对心肌具有一定的保护作用。
목적관찰우미탁미정( Dex)대비체외순배관상동맥방로이식술( OPCABG)환자위술기심기손상적보호작용。방법선택행OPCABG적환자60례( ASAII~Ⅲ급,심공능II~Ⅲ급),수궤쌍맹분위Dex조(D조,수주Dex)화공백대조조(C조,수주0.9%적록화납용액)각30례,분량개계단급약,선이1μg/(kg·h)경미량주사빙정주급약15분종,수후이0.5μg/(kg·h)유지급약지수술결속。분별우입실후( T0),혈관문합완필( T1),술후6、12、24소시( T2、T3、T4)추취중심정맥혈,측정IMA화 cTnI。결과량조환자입실후IMA、cTnI비교차이무통계학의의(P>0.05),D조재혈관문합완필,술후6、12소시IMA균현저저우C조(P<0.01),술후6、12、24소시cTnI균현저저우C조(P<0.05)。결론우미탁미정능은정혈류동역학,감경비체외순배관상동맥방로이식술환자위술기심기손상,대심기구유일정적보호작용。
Objective To observe the myocardial protection effect of dexmedetomidine in off-pump coronary artery bypass grafting ( OPCABG) . Method 60 patients ( American Society of AnesthesiologistsII~Ⅲ, cardiac function grade II~Ⅲ) who suffered OPCABG were randomly divided into Dex group (group D, infusion of Dex,n=20) and control group ( group C, infusion of normal saline,n=20) . The drugs were given by two stages:first injection at 1μg/(kg·h)for 15 min, and then maintained at 0. 5μg/(kg·h). IMA and cTnI were determined with the central venous bleed that extracted after the burglary ( T0 ) , at ascular anastomosis completed ( T1 ) , 6、12、24 h at postoperative ( T2、T3、T4 ) , respectively. Result The difference of IMA and cTnIafter the burglary ( T0 ) were not statistically significant(P>0. 05). After vascular anastomosis has completed, IMA after postoperative 6、12 h in group D were significantly lower than C group (P<0. 01), cTnIafter postoperative 6、12、24 h in group D were sig-nificantly lower than C group (P<0. 05). Conclusion Dexmedetomidine has obvious protective effect on the myo-cardium, it can stable hemodynamics, reduce OPCABG in patients with perioperative myocardial damage.