中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2013年
10期
617-619
,共3页
右旋美托咪啶%婴儿%儿童%心肺转流术%脑损伤
右鏇美託咪啶%嬰兒%兒童%心肺轉流術%腦損傷
우선미탁미정%영인%인동%심폐전류술%뇌손상
Dexmedetomidine%Infant%Child%Cardiopulmonary bypass%Brain injuries
目的 观察患儿体外循环(CPB)下应用右旋美托咪啶(Dex)对脑损伤的影响.方法 选择60例先天性心脏病患儿,按随机数字法分为研究组(D1组、D2组)和对照组(N组),每组20人.麻醉平稳后D1组静脉注入Dex 1.0 μg/kg,术中0.2μg·kg-1·h-1静脉泵注,直至手术结束；D2组静脉注入Dex 0.5μg/kg,术中0.1μg·kg-1 ·h-1静脉泵注,注射速度同D1组；N组静注0.9％生理盐水,输注速度、麻醉处理同实验组.分别于手术前(T1)、CPB结束时(T2)、CPB结束后2 h(T3)、6 h(T4)、24 h(T5)取患儿血样送化验室检测,收集记录围手术期数据.结果 3组患儿的一般情况差异无统计学意义(P＞0.05).T1时,3组患儿血样中星形胶质细胞S-100β蛋白(S-100β蛋白)和神经元特异性烯醇化酶(NSE)差异无统计学意义(P＞0.05).N组T2、T3、T4、T5时点的S-100β蛋白和NSE较T1时升高,差异有统计学意义(P＜0.05).T2时点,N组与D1、D2组相比,S-100β蛋白和NSE明显升高(P＜0.01),且D2组较D1组S-100β蛋白和NSE高.各组间患儿围手术期的心率、血压等血流动力学指标差异无统计学意义(P＞0.05).结论 Dex可减少患儿CPB过程中S-100β和NSE的上升幅度,减轻CPB造成的脑损伤.
目的 觀察患兒體外循環(CPB)下應用右鏇美託咪啶(Dex)對腦損傷的影響.方法 選擇60例先天性心髒病患兒,按隨機數字法分為研究組(D1組、D2組)和對照組(N組),每組20人.痳醉平穩後D1組靜脈註入Dex 1.0 μg/kg,術中0.2μg·kg-1·h-1靜脈泵註,直至手術結束；D2組靜脈註入Dex 0.5μg/kg,術中0.1μg·kg-1 ·h-1靜脈泵註,註射速度同D1組；N組靜註0.9％生理鹽水,輸註速度、痳醉處理同實驗組.分彆于手術前(T1)、CPB結束時(T2)、CPB結束後2 h(T3)、6 h(T4)、24 h(T5)取患兒血樣送化驗室檢測,收集記錄圍手術期數據.結果 3組患兒的一般情況差異無統計學意義(P＞0.05).T1時,3組患兒血樣中星形膠質細胞S-100β蛋白(S-100β蛋白)和神經元特異性烯醇化酶(NSE)差異無統計學意義(P＞0.05).N組T2、T3、T4、T5時點的S-100β蛋白和NSE較T1時升高,差異有統計學意義(P＜0.05).T2時點,N組與D1、D2組相比,S-100β蛋白和NSE明顯升高(P＜0.01),且D2組較D1組S-100β蛋白和NSE高.各組間患兒圍手術期的心率、血壓等血流動力學指標差異無統計學意義(P＞0.05).結論 Dex可減少患兒CPB過程中S-100β和NSE的上升幅度,減輕CPB造成的腦損傷.
목적 관찰환인체외순배(CPB)하응용우선미탁미정(Dex)대뇌손상적영향.방법 선택60례선천성심장병환인,안수궤수자법분위연구조(D1조、D2조)화대조조(N조),매조20인.마취평은후D1조정맥주입Dex 1.0 μg/kg,술중0.2μg·kg-1·h-1정맥빙주,직지수술결속；D2조정맥주입Dex 0.5μg/kg,술중0.1μg·kg-1 ·h-1정맥빙주,주사속도동D1조；N조정주0.9％생리염수,수주속도、마취처리동실험조.분별우수술전(T1)、CPB결속시(T2)、CPB결속후2 h(T3)、6 h(T4)、24 h(T5)취환인혈양송화험실검측,수집기록위수술기수거.결과 3조환인적일반정황차이무통계학의의(P＞0.05).T1시,3조환인혈양중성형효질세포S-100β단백(S-100β단백)화신경원특이성희순화매(NSE)차이무통계학의의(P＞0.05).N조T2、T3、T4、T5시점적S-100β단백화NSE교T1시승고,차이유통계학의의(P＜0.05).T2시점,N조여D1、D2조상비,S-100β단백화NSE명현승고(P＜0.01),차D2조교D1조S-100β단백화NSE고.각조간환인위수술기적심솔、혈압등혈류동역학지표차이무통계학의의(P＞0.05).결론 Dex가감소환인CPB과정중S-100β화NSE적상승폭도,감경CPB조성적뇌손상.
Objective To observe the effect of application of dexmedetomidine on cerebral injury in infants after cardiopulmonary bypass.Methods 60 cases of congenital heart disease were divided into 3 groups,each group 20 infants,namely D1,D2 and N group.Group D1 dexmedetomidine 1.0μg/kg,in 0.2μg · kg-1 · h-1 intravenous infusion,until the end of operation; group D2 with dexmedetomidine 0.5 μg/kg,in 0.1 μg · kg-1 · h-1,drug concentration and injection speed was the same as the group D1.Group N intravenous normal saline in the whole operation process,infusion speed was the same as the experimental group,anesthesia and experimental group agreement.Take blood samples sent to laboratory before the operation (T1),at the end of CPB (T2),after CPB 2 h (T3),6 h (T4),24 h (T5) respectively,colleced records of perioperative data.Results There were no significant in 3 groups,for infant's age,weight,operation time,CPB time difference (P ＞0.05).In T1,there was no statistical difference between the 3 groups in S-100β protein and NSE (P ＞ 0.05).In group N,S-100β protein and NSE in T2,T3,T4,T5 were increased significantly than the level in T1 (P ＜ 0.05).In T2,compared with group D2,S-100β and NSE increased significantly in group N and D1 (P ＜ 0.01),and there were more in D2 than D1 group.Differences in heart rate,blood pressure and hemodynamics were observed in infant during perioperative period was not significant (P ＞ 0.05).Conclusion Dexmedetomidine can reduce the ascensional range of S-100β and NSE in infant after cardiopulmonary bypass,and relieve the cerebral injury.
