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目的探讨右美托咪啶对脑肿瘤手术患者血流动力学和术后恢复的影响。方法择期行脑肿瘤手术切除的60例老年患者随机分成右美托咪啶组(给予右美托咪啶)和对照组(给予生理盐水),监测并记录麻醉诱导前后不同时间段的心率、平均动脉压变化。拔管之后10 min行OAA/S评级和术后24 h行VAS评分。结果 1在T4~T8时间点,右美托咪啶组平均动脉压(MAP)显著降低于对照组(P<0.05)。在T4~T6时间点,与对照组相比,右美托咪啶组心率显著降低于对照组(P<0.05),其他时间点两组的心率均在正常范围,差异无统计学意义(P>0.05)。2术后恢复情况:术后右美托咪啶组呼之睁眼时间和拔管时间均比对照组短,差异有统计学意义(P<0.05)。拔管之后10 min,右美托咪啶组OAA/S评级显著高于对照组(P<0.05);术后24 h进行VAS评分,右美托咪啶组显著优于对照组(P<0.05);采用多因素相关分析,发现MAP、心率分别与睁眼时间、拔管时间、OAA/S评级、VAS评分具有一定的相关性(P<0.05或P<0.01)。结论右美托咪啶可以显著改善老年脑肿瘤患者手术过程及术后的血流动力学的异常,对术后的恢复有很大帮助。
Objective To investigate the effect of dexmedetomidine on hemodynamics and postoperative recovery in patients with brain tumor. Methods Sixty elder patients undergoing elective brain tumor resection were randomly divided into dexmedetomidine group (given dexmedetomidine) and control group (given saline). The heart rate at different time points before and after induction of anesthesia was monitored and recorded. The mean Arterial pressure changes. OAA / S rating was performed 10 min after extubation and VAS score at 24 h after extubation. Results 1 At the time of T4 ~ T8, mean arterial pressure (MAP) in the dexmedetomidine group was significantly lower than that in the control group (P <0.05). At T4 ~ T6, compared with the control group, the heart rate of the dexmedetomidine group was significantly lower than that of the control group (P <0.05); at other time points, the heart rate of the two groups were in the normal range, with no significant difference (P > 0.05). 2 postoperative recovery: postoperative dexmedetomidine group eyes open time and extubation time shorter than the control group, the difference was statistically significant (P <0.05). At 10 min after extubation, the OAA / S rating of dexmedetomidine group was significantly higher than that of control group (P <0.05); VAS score at 24 h after dexmedetomidine group was significantly better than that of control group (P <0.05) ). Multivariate analysis showed that MAP and heart rate were correlated with eyes open time, extubation time, OAA / S rating and VAS score, respectively (P <0.05 or P <0.01). Conclusion Dexmedetomidine can significantly improve the abnormalities of the hemodynamics during the operation and the postoperative hemiplegia in elderly patients with brain tumors, which is of great help to the postoperative recovery.