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右美托咪定联合七氟醚麻醉对EDAS缺血性烟雾病患儿脑氧代谢的影响 被引量:2

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摘要 目的观察右美托咪定联合七氟醚麻醉对行脑-硬膜-动脉血管融通术(encephalo-duro-arteriosynangiosis,EDAS)缺血性烟雾病患儿脑氧代谢的影响。方法收集择期行EDAS的缺血性烟雾病患儿40例,采用随机数字表法将患儿分为2组:七氟醚(S组)20例和右美托咪定联合七氟醚组(DS组)20例。2组术中均使用七氟醚吸入麻醉参与全身麻醉的麻醉维持,而DS组插管后即刻给予右美托咪定辅助维持全身麻醉,分别记录患儿入手术室麻醉开始前(T1)、气管导管插入即刻(T_2)、手术开始切皮即刻(T_3)、切开脑硬膜即刻(T_4)、脑硬膜切开后1h(T_5)、关闭脑硬膜即刻(T_6)的平均动脉压及心率。测定T_3、T_4、T_5、T_6时间点颈内静脉球血氧饱和度(jugular venous oxygen saturation,SjvO_2)、脑动静脉血氧含量差(arteriovenous oxygen content difference,AV-DO_2)及脑氧摄取率(cerebral extraction of oxygen,CO_2ER)。结果 S组和DS组AV-DO_2、CO_2ER均呈逐渐下降趋势,SjvO_2均呈逐渐升高趋势,但DS组下降和升高幅度更大,2组以上指标在组间、不同时点间差异均有统计学意义(P<0.05),2组AV-DO_2、SjvO_2在组间·不同时点间交互作用差异均有统计学意义(P<0.05),CO_2ER在组间·不同时点间交互作用差异无统计学意义(P>0.05)。结论右美托咪定联合七氟醚维持全身麻醉对行EDAS的缺血性烟雾病患儿在脑氧代谢方面有更明显优势,对脑保护有一定的积极作用。
出处 《河北医科大学学报》 CAS 2016年第9期1096-1099,共4页 Journal of Hebei Medical University
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