右美托咪定对颅脑损伤手术病人神经功能、脑氧代谢及炎症因子的调节作用

目的:探讨右美托咪定对颅脑手术病人神经功能、脑氧代谢及炎症因子的调节作用。方法:选择颅脑手术病人98例，按照抽签法分为对照组和观察组，各49例。对照组行常规麻醉，观察组基于对照组联合右美托咪啶麻醉，比较2组术后神经功能[神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、S100β]、脑氧代谢[桡动脉血氧含量（CjvO₂）、桡动脉血氧饱和度（SjvO₂）、颈内静脉血氧含量（CaO₂）]、炎症因子[白细胞介素-6（IL-6）、IL-8、肿瘤坏死因子-α（TNF-α）]水平变化，术后恢复情况以及不良反应。结果:术前2组神经功能指标水平比较差异无统计学意义（P>0.05）；术后，2组神经功能指标水平均有上升，且观察组明显优于对照组（P<0.01）。术前2组脑氧代谢指标水平比较差异无统计学意义（P>0.05）；术后，2组脑氧代谢指标水平均有降低，观察组下降程度更小（P<0.01）。术前2组炎症因子水平比较差异无统计学意义（P>0.05）；术后，2组炎症因子水平均有下降，且观察组低于对照组（P<0.01）。2组苏醒时间、拔管时间及病死率和不良反应率比较无统计学意义（P>0.05）。结论:右美托咪啶对颅脑手术病人神经功能有保护作用，能够降低脑氧代谢，降低炎症因子水平。

The regulation effect of dexmedetomidine on nerve function,cerebral oxygen metabolism and inflammatory factor in craniocerebral operation patients

Objective: To investigate the regulation effects of dexmedetomidine on nerve function,cerebral oxygen metabolism and inflammatory factor in craniocerebral operation patients.Methods: Ninety-eight patients treated with cerebral surgery were divided into the control group and observation group according to the draw method(45 cases each group).The control group was treated with routine anesthesia,and the observation group was treated with dexmedetomidine additionally based on control group.The levels of postoperative neurological function[including neuron specificity enolization enzyme(NSE),myelin basic protein(MBP) and S100β],brain oxygen metabolism[including radial artery blood oxygen content(CjvO₂),radial artery blood oxygen saturation(SjvO₂),internal carotid artery blood oxygen content(CaO₂)],inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α)],postoperative recovery and adverse reactions between two groups were compared.Results: Level of neurologic functional indicators in both groups before surgery exhibited no statistically significant difference(P>0.05).After surgery,the level of nerve function indicators increased in both groups,which in the observation group was significantly better than that in the control group(P<0.01).Cerebral oxygen metabolism in both groups before surgery exhibited no significant difference(P>0.05).After surgery,the level of cerebral oxygen metabolism in both groups was decreased,while that of the observation group decreased more(P<0.01).The level of inflammatory factors in both groups before surgery showed no statistically significant difference(P>0.05).After surgery,the level of inflammatory factors in both groups was decreased,which in the observation group was lower than that in the control group(P<0.01).The terms of wake time,tube removal time,mortality rate and adverse reaction rate in both groups showed no statistically significant difference(P>0.05).Conclusions: Dexmedetomidine can protect the nerve function,reduce the cerebral oxygen metabolism and inflammatory factors in patients treated with craniocerebral surgery.