解放军医药杂志2017，Vol.29Issue(12)：96-99,112,5.DOI:10.3969/j.issn.2095-140X.2017.12.027
不同剂量右美托咪定对体外循环下心脏瓣膜置换手术患者血流动力学的影响
Effects of Different Doses of Dexmedetomidine on Hemodynamics in Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass
摘要
Abstract
Objective To investigate effect of different doses of Dexmedetomidine on hemodynamics in patients un-dergoing cardiac valve replacement under cardiopulmonary bypass( CPB) . Methods Clinical data of 120 patients with rheu-matic heart disease, who had undergone cardiac valve replacement during February 2013 and December 2016, was retrospec-tively analyzed, and the patients were divided into group A, B, and C according to different doses of Dexmedetomidine ( n=40 for each group). Group A was given the same volume of normal saline, and group B was treated with 0. 5 μg/kg Dexme-detomidine by intravenous injection, and group C was treated with 1. 0μg/kg Dexmedetomidine by intravenous injection. Lev-els of myocardial injury markers before medication, at 10 min before CPB stopping, at the end of surgery, at 8 and 24 h after operation, and levels of hemodynamic parameters before medication (T0), at the time of using Dexmedetomidine (T1), after cutting skin (T2), after rending sternum (T3), before CBP (T4) and at 10 min after CBP stopping (T5) were observed and compared in 3 groups. Conditions of adverse reactions and complications were observed in 3 groups. Results At 10 min be-fore CPB stopping, at the end of surgery, at 8 and 24 h after operation, levels of troponin-I, heart type fatty acid binding pro-tein and creatine kinase isoenzyme in group B and C were significantly lower than those in group A, and the levels in group B were significantly lower than those in group C (P<0. 05). At T1-T4, heart rates in group B and C were significantly lower than those in group A, and the rates in group C were significantly lower than those in group B (P<0. 05). At T1-T5, values of the mean arterial pressure in group B and C were significantly higher than those in group A (P<0. 05). There were signifi-cant differences in incidence rate of anesthetic adverse reactions among 3 groups (P<0. 05). Conclusion Intravenous infu-sion of 0. 5 μg/kg Dexmedetomidine can maximally reduce myocardial injury and maintain the stability of hemodynamics sim-ultaneously with safety in patients undergoing cardiac valve replacement under CPB after anesthetic induction.关键词
右美托咪定/体外循环/心脏瓣膜置换手术:血流动力学Key words
Dexmedetomidine/Extracorporeal circulation/Heart valve replacement surgery/Hemodynamics分类
医药卫生引用本文复制引用
叶永科..不同剂量右美托咪定对体外循环下心脏瓣膜置换手术患者血流动力学的影响[J].解放军医药杂志,2017,29(12):96-99,112,5.基金项目
陕西省教育厅专项科研资助项目(15JK1627) （15JK1627）
