摘要
目的观察右美托咪啶对重度颅脑损伤患者术后颅内压的缓解作用及疗效。方法对77例行急诊重度颅脑损伤手术的患者按照随机原则进行临床分组研究。对照组38例采用常规麻醉及维持麻醉方案,观察组39例在对照组基础上使用右美托咪啶静滴。观察术前、术后24h、术后48h两组患者血液中白细胞介素1β(IL-1β)以及肿瘤坏死因子-α(TNF-α)的水平,并分别对术后为缓解脑水肿使用的地塞米松、甘露醇、甘油果糖用量进行记录。结果与术前相比,术后24h、48h两组患者的IL-1β、TNF-α水平均呈现明显上升,观察组与对照组比较,可见观察组上升趋势低于对照组,差异具有高度统计学意义(P<0.01);与对照组比较,观察组患者术后地塞米松、甘露醇、甘油果糖三种药物的使用总剂量降低,差异有高度统计学意义(P<0.01)。结论右美托咪啶能够有效缓解重度颅脑损伤患者术后颅内压过高,其作用机制与下调IL-1β、TNF-α水平有关。
Objective To observe the relief and curative effect of Dexmedetomidine on postoperative intracranial pressure of the patients with severe craniocerebral injury. Methods All of the 77 emergency severe craniocerebral injury patients with surgery were studied by groups from May 2010 to May 2012 in hospital. Thirty-eight eases of the control group used the conventional anesthesia and maintain anesthesia scheme, thirty-nine cases of the observation group used Dexmedetomidine based on the treatment of the control group. The patients of the two groups were observed IL-1β and TNF-α levels before and after operation, and the amounts of Dexamethasone, Mannitol and Glycerin fructose used for relieving cerebral edema at the postoperative were recorded. Results Compared with preoperative, the levels of IL-1β and TNF-α of the both groups had risen substantially in the 24 hours and 48 hours after the surgery. The two groups were compared, the upward trend of the observation group was lower than the control group and the difference was significant statistically （ P 〈 0. 01 ）. Compared the using total dose of postoperative Dexamethasone, Mannitol and Glycerin fructose, the observation group was significantly lower than the control group and the difference was significant statistically （P 〈 0.01 ）. Conclusion Dexmedetomidine can effectively ease high intracranial pressure of the patients with severe craniocerebral injury, and its mechanism of action may be relevant to cuting the levels of IL-β and INF-α.
出处
《中华损伤与修复杂志（电子版）》
CAS
2013年第1期42-44,共3页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
关键词
右美托咪啶
颅脑损伤
颅内压
Dexmedetomidine
Craniocerebral Trauma
Intracranial Pressure
