中外医疗
中外醫療
중외의료
China Foreign Medical Treatment
2015年
24期
149-151
,共3页
右美托咪定%老年患者%术后恢复期%心肌保护
右美託咪定%老年患者%術後恢複期%心肌保護
우미탁미정%노년환자%술후회복기%심기보호
Dexmedetomidine%Elderly patients%Postoperative convalescence%Myocardial protection
目的:探讨右美托咪定对老年患者术后恢复期的心肌保护效应。方法随机选取该院2013年3月-2015年3月择期腹部手术的老年患者80例,随机分为两组(n=40):对照组(C组)和右美托咪定组(D组)。术毕转入重症监护室(ICU),D组静脉注射右美托咪定0.5 ug/kg作为负荷剂量,然后以0.3 ug/(kg·h)维持至拔出气管导管;C组给予等容量的生理盐水。记录MAP和HR变化,分析心型脂肪酸结合蛋白(H-FABP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)的浓度变化。结果使用右美托咪定后D组HR明显减慢,MAP明显降低,与C组比较,差异有统计学意义(P<0.05)。与C组比较,D组血清H-FABP、CK-MB、cTnI浓度明显降低(P<0.05)。结论术后恢复期给予0.5 ug/kg负荷剂量的右美托咪定,随后以0.3 ug/(kg·h)持续静脉泵注,可减少老年患者血流动力学波动,降低心肌损伤,产生心肌保护效应。
目的:探討右美託咪定對老年患者術後恢複期的心肌保護效應。方法隨機選取該院2013年3月-2015年3月擇期腹部手術的老年患者80例,隨機分為兩組(n=40):對照組(C組)和右美託咪定組(D組)。術畢轉入重癥鑑護室(ICU),D組靜脈註射右美託咪定0.5 ug/kg作為負荷劑量,然後以0.3 ug/(kg·h)維持至拔齣氣管導管;C組給予等容量的生理鹽水。記錄MAP和HR變化,分析心型脂肪痠結閤蛋白(H-FABP)、肌痠激酶同工酶(CK-MB)、肌鈣蛋白I(cTnI)的濃度變化。結果使用右美託咪定後D組HR明顯減慢,MAP明顯降低,與C組比較,差異有統計學意義(P<0.05)。與C組比較,D組血清H-FABP、CK-MB、cTnI濃度明顯降低(P<0.05)。結論術後恢複期給予0.5 ug/kg負荷劑量的右美託咪定,隨後以0.3 ug/(kg·h)持續靜脈泵註,可減少老年患者血流動力學波動,降低心肌損傷,產生心肌保護效應。
목적:탐토우미탁미정대노년환자술후회복기적심기보호효응。방법수궤선취해원2013년3월-2015년3월택기복부수술적노년환자80례,수궤분위량조(n=40):대조조(C조)화우미탁미정조(D조)。술필전입중증감호실(ICU),D조정맥주사우미탁미정0.5 ug/kg작위부하제량,연후이0.3 ug/(kg·h)유지지발출기관도관;C조급여등용량적생리염수。기록MAP화HR변화,분석심형지방산결합단백(H-FABP)、기산격매동공매(CK-MB)、기개단백I(cTnI)적농도변화。결과사용우미탁미정후D조HR명현감만,MAP명현강저,여C조비교,차이유통계학의의(P<0.05)。여C조비교,D조혈청H-FABP、CK-MB、cTnI농도명현강저(P<0.05)。결론술후회복기급여0.5 ug/kg부하제량적우미탁미정,수후이0.3 ug/(kg·h)지속정맥빙주,가감소노년환자혈류동역학파동,강저심기손상,산생심기보호효응。
Objective To investigate the effect of dexmedetomidine on recovery of myocardial protective effect of aged patients. Methods 80 elderly patients undergoing elective abdominal surgery were randomly divided into two groups (n=40): control group (group C) and dexmedetomidine group (group D). Postoperative intensive care unit (ICU), group D intravenous dexmedetomidine 0.5 ug/kg as loading dose, and then to 0.3 ug/(kg·h) to pull out the endotracheal tube; C group received the same volume of saline. Record MAP and HR changes, analysis of heart type fatty acid binding protein (H-FABP), creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI) concentration. Results The use of dexmedetomidine group D HR decreased significantly, MAP de-creased significantly, compared with the C group, the difference was statistically significant (P<0.05). Compared with C group, D group, serum H-FABP, CK-MB, cTnI concentrations were significantly decreased(P<0.05). Conclusion Postoperative recovery for 0.5 ug/kg loading dose of dexmedetomidine 0.3 ug/(kg·h), followed by continuous intravenous infusion in elderly patients, can re-duce the fluctuation of hemodynamics, reduce myocardial injury, resulting in myocardial protection effect.