临床医学研究与实践2024,Vol.9Issue(6) :92-95.DOI:10.19347/j.cnki.2096-1413.202406023

不同剂量右美托咪定对CPB心脏瓣膜置换术患者手术结局及心肌损伤情况的影响

Effects of different doses of dexmedetomidine on surgical outcome and myocardial injury in patients undergoing cardiac valve replacement with CPB

甄万里 朱雅萍 宋磊军 金戈
临床医学研究与实践2024,Vol.9Issue(6) :92-95.DOI:10.19347/j.cnki.2096-1413.202406023

不同剂量右美托咪定对CPB心脏瓣膜置换术患者手术结局及心肌损伤情况的影响

Effects of different doses of dexmedetomidine on surgical outcome and myocardial injury in patients undergoing cardiac valve replacement with CPB

甄万里 1朱雅萍 1宋磊军 1金戈1
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作者信息

  • 1. 郑州市第七人民医院麻醉科,河南 郑州,450000
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摘要

目的 分析行体外循环(CPB)心脏瓣膜置换术患者采用不同剂量右美托咪定对手术结局及心肌损伤情况的影响.方法 选取我院 2021 年1月至12 月收治的 202 例行CPB心脏瓣膜置换术患者作为研究对象,并以右美托咪定使用剂量将其分为 0.2 μg组(101 例,0.2 μg右美托咪定)和 0.4 μg组(101 例,0.4 μg右美托咪定).比较两组的麻醉效果.结果 两组患者的CPB时长、主动脉阻断时长和心脏自动复跳率比较,差异无统计学意义(P﹥0.05).术前及术后,两组的脑利钠肽(BNP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、可溶性生长刺激表达基因2 蛋白(sST2)、心型脂肪酸结合蛋白(hFABP)水平比较,差异均无统计学意义(P﹥0.05).两组患者的术中心动过缓、低血压、呼吸抑制和术后头晕发生率比较,差异无统计学意义(P﹥0.05);0.4 μg组的术后恶心呕吐、认知障碍发生率显著高于 0.2 μg组(P﹤0.05).结论 对行CPB心脏瓣膜置换术患者采用 0.2 μg右美托咪定进行手术麻醉可取得更佳的手术预后保障.

Abstract

Objective To analyze the effects of different doses of dexmedetomidine on surgical outcome and myocardial injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods A total of 202 patients undergoing cardiac valve replacement with CPB in our hospital from January to December 2021 were selected as the research objects,and the patients were divided into 0.2 μg group(101 cases,0.2 μg dexmedetomidine)and 0.4 μg group(101 cases,0.4 μg dexmedetomidine)according to the dose of dexmedetomidine.The anesthetic effects of the two groups were compared.Results There were no significant differences in CPB duration,aortic occlusion duration and automatic heart resuscitation rate between the two groups(P>0.05).Before and after operation,there were no significant differences in the levels of brain natriuretic peptide(BNP),creatine kinase MB(CK-MB),cardiac troponin T(cTnT),soluble growth stimulation expressed gene 2 protein(sST2)and heart-type fatty acid binding protein(hFABP)between the two groups(P>0.05).There were no significant differences in the incidences of intraoperative bradycardia,hypotension,respiratory depression and postoperative dizziness between the two groups(P>0.05);the incidence of postoperative nausea and vomiting and cognitive impairment in the 0.4 μg group were significantly higher than those in the 0.2 μg group(P<0.05).Conclusion The use of 0.2 μg dexmedetomidine for surgical anesthesia in patients undergoing cardiac valve replacement with CPB can achieve better surgical prognosis.

关键词

心脏瓣膜置换术/右美托咪定/体外循环/手术结局/心肌损伤

Key words

cardiac valve replacement/dexmedetomidine/cardiopulmonary bypass/surgical outcome/myocardial injury

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出版年

2024
临床医学研究与实践

临床医学研究与实践

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