右美托咪定对颅内动脉瘤栓塞术患者围术期的影响

目的观察右美托咪定对气管插管全麻下颅内动脉瘤栓塞术患者围术期的影响。方法选取湖北医药学院附属人民医院36例行颅内动脉瘤介人手术患者，随机分为D组和C组，每组各18例。D组在麻醉诱导前10min静脉泵注负荷量的右美托咪啶0．6μg／kg，继以0．4μg／（kg·h）持续泵注，C组以同样的方法泵注等量的生理盐水。两组均采用气管内插管全凭静脉麻醉。观察并记录人室（T0）、诱导前（T，）、插管前（T2）、插管后即刻（T3）、手术开始（T4）、弹簧圈放置时（T5）、术毕时（T6）、拔管前（T7）、拔管后即刻（T8）两组患者的平均动脉压（MAP）、心率（HR）、脉搏氧饱和度（SpO2），记录术后恢复情况及不良反应，记录使用血管活性药物的种类和人数。结果与T0时比较，在T1时D组的MAP、HR明显减低（P〈0．05）；在T1、T3、T4、T7、T8时间点，D组MAP、HR与C组相比明显减低（P〈0．05）。与C组相比，D组的术后恢复时间没有显著差别，但不良事件发生率明显减少（P〈0．05）。结论在气管内插管全麻颅内动脉瘤栓塞术中应用右美托咪定有利于维持围麻醉期皿液动力学稳定，降低动脉瘤破裂风险．术后并发症少。

Affection of Dexmedetomdine on perioperative patients with intracranial aneurysm administration in interventional treatment

Objective To evaluate the effect of dexmedetomidine in the patient with intracranial aneurysm during the perioperative period of interventional treatment. Methods A total of 38 patients with intracranial aneurysm underwent interventional treatment in the People＇s hospital affiliated to Hubei university of medicine were randomly divided into group D and group C. The patients of Group D were intravenously administered with 0.6 I~g/kg Dexmedetomidine pre- operatively and 0.4 Ixg/（kg.h） during operation, while the same amount of saline would be used in Group C. Two groups all applied endotraeheal intubation total intravenous anesthesia （TIVA）. Mean artery pressure （MAP） and heart rate （HR） of the patients were measured and compared at the time points of baseline （To）, before induction （TI）, pre-in- tubation （T2）, just after intubation （T3）, operation began （T4）, parent artery embolization （T~）, at the end of operation （T6）, pre-extubation （TT）, just after extubation （Ts）. The used amount of vasoactive drugs and postoperative recovery conditions and complications were compared between groups. Resets The blood pressure and heart rate of group D were lower than group C at the time of T1, Ta, T4, T7, T8 （P 〈 0.05）. Compared with group C, the postoperative recovery time of group D was no obvious defference, but the incidence of adverse events and the used amount of vasoactive drugs were reduced in group D （P 〈 0.05）. Conclusion Dexmedetomidine used as a peri-anaesthetic drugs for interventional treatment of intracranial aneurysm patient is beneficial to reduce the blood pressure and heart rate, and stabilize hemodynamics, thus it can reduce the risk of aneurvsm ruoture and the incidence of adverse events.