右美托咪定对行三叉神经微血管减压患者血清炎症因子及凝血功能的影响

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摘要目的探究右美托咪定（DEX）对行三叉神经微血管减压患者围手术期血清炎症因子及凝血功能的影响。方法选取2017 年1 月至2020 年10 月于徐州市中心医院收治的60 例行三叉神经微血管减压患者为研究对象，采用随机数字表法分为 DEX 组（30 例）和对照组（30 例）。 DEX 组给予 DEX 负荷剂量 1 μg/kg，维持剂量0.5 μg/（kg·h），对照组于同时间给予等量生理盐水。比较两组手术时间，麻醉时间，观察预给药前（T0）、插管后（T1）、手术前 10 min（T2）、术后 1 h（T3）的心率（HR）、平均动脉压（MAP）的变化及肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平和凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）。结果两组的手术时间和麻醉时间比较，差异无统计学意义（P>0.05）。两组 T0 时的 MAP、HR、TNF-α、IL-6 水平比较，差异无统计学意义（P>0.05）；DEX 组T1、T2、T3 时间点 MAP、HR、TNF-α、IL-6 水平低于对照组，差异有统计学意义（P<0.05）。两组 T0、T1、T2、T3 时 PT、APTT 水平比较，差异无统计学意义（P>0.05）。结论 DEX 在三叉神经微血管减压术中麻醉效果显著，可有效减轻机体应激反应。然而，没有明显证据表明右美托咪定的抗凝作用与抗炎作用之间存在联系，可能仅与其对患者的血流动力学改善有关。

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	王荣国
	丁文平
	刘倩
	满园园▲

关键词 ：右美托咪定, 显微血管减压术, 炎症因子, 凝血功能

Abstract：Objective To investigate the effects of Dexmedetomidine (DEX) on serum inflammatory factors and coagulation function in perioperative patients undergoing trigeminal nerve microvascular decompression. Methods A total of 60 patients with trigeminal nerve microvascular decompression admitted to Xuzhou Central Hospital from January 2017 to October 2020 were selected as the study subjects,and were divided into DEX group(30 cases)and control group(30 cases)by random number table method. DEX group was given DEX load dose of 1 μg/kg, maintenance dose of 0.5 μg/ (kg·h),and control group was given normal saline at the same time. Operation time and anesthesia time were compared between the two groups, and changes of heart rate (HR) and mean arterial pressure (MAP), tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) levels and prothrombin time (PT), activated partial thrombin time (APTT) were observed before drug administration (T0), after intubation (T1), 10 min before surgery (T2), and 1 h after surgery (T3). Results There was no significant difference in operation time and anesthesia time between the two groups (P>0.05). There were no significant differences in MAP, HR, TNF-α and IL-6 levels between the two groups at T0 (P>0.05). MAP, HR, TNF-α and IL-6 levels at T1, T2 and T3 in DEX group were lower than those in control group, the differences were statistically significant (P<0.05). There were no significant differences in PT and APTT levels between the two groups at T0, T1, T2 and T3(P>0.05). Conclusion DEX has a significant anesthetic effect in trigeminal microvascular decompression, and can effectively reduced the stress response of the body. However, there is no obvious evidence to link the coagulation function enhancement of DEX with its inhibitory effects on inflammatory responses, which might be just associated with its attenuation effects on hemodynamics of patients.

Key words： Dexmedetomidine Microvascular decompression surgery Coagulation function Inflammatory response

作者简介: 王荣国（1982-），男，硕士，副主任医师，研究方向：围手术期认知功功能障碍机制，主要从事临床麻醉工作

引用本文:

王荣国;丁文平;刘倩;满园园▲. 右美托咪定对行三叉神经微血管减压患者血清炎症因子及凝血功能的影响[J]. 中国当代医药, 2021, 28(34): 139-142转146.
WANG Rong-guo;DING Wen-ping;LIU Qian;MAN Yuan-yuan▲. Effect of Dexmedetomidine on inflammatory cytokines and coagulation function of the patients undergoing microvascular decompression surgery. 中国当代医药, 2021, 28(34): 139-142转146.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I34/139

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