| 陈良义，陈星宇，张建平，翁磊华.右美托咪定静脉麻醉在急性前循环闭塞性卒中血管内治疗中的疗效及安全性[J].神经损伤功能重建,2023,(11):626-629 |
| 右美托咪定静脉麻醉在急性前循环闭塞性卒中血管内治疗中的疗效及安全性 |
| Efficacy and Safety of Dexmedetomidine in Intravenous Anesthesia for EndovascularTreatment of Acute Anterior Circulation Ischemic Stroke |
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| DOI： |
| 中文关键词: 右美托咪定 急性前循环闭塞性卒中 血管内治疗 S100-β蛋白 疗效 安全性 |
| 英文关键词: dexmedetomidine acute anterior circulation obliteration stroke endovascular therapy S100-β
protein efficacy safety |
| 基金项目:福建省自然科学基
金（No. 2020J0529
0） |
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| 中文摘要: |
| 目的：探索右美托咪定静脉麻醉在急性前循环闭塞性卒中血管内治疗（EVT）中应用的疗效。方法：
选择2019年6月至2021年6月厦门大学附属中山医院诊治的行EVT治疗的急性前循环闭塞性卒中患者
116 例，采用随机数字表法分为局部麻醉组（对照组）和局部麻醉联合术中右美托咪定静脉麻醉组（观察
组）。比较2组患者疗效、并发症、S100-β及美国国立卫生院脑卒中量表（NIHSS）评分差异。结果：观察组血
压波动发生率、穿刺到血管再通时间（PRT）、受线时间及取栓次数低于对照组（P＜0.05），首次再通率高于对
照组（P＜0.05）。2组的血氧饱和度（SpO2）、肺部感染率、死亡率、总再通率及症状性颅内出血（SICH）的发
生率差异无统计学意义（P＞0.05）。2组术前及术后7 d 的NIHSS评分均无统计学差异（P＞0.05），但观察组
术后7 d 时NIHSS评分下降≥8分的患者比例显著高于对照组（P＜0.05）；2组术前S100-β水平差异无统计
学差异（P＞0.05），术后3d，观察组的S100-β水平低于对照组（P＜0.05）。结论：右美托咪定应用于急性前循
环闭塞性卒中EVT可提高疗效及降低神经功能损伤，具有高效安全等优点。 |
| 英文摘要: |
| To explore the efficacy of dexmedetomidine in intravenous anesthesia for endovascular
treatment (EVT) of acute anterior circulation ischemic stroke. Methods: A total of 116 patients with acute
anterior circulation ischemic stroke treated by EVT in Zhongshan Hospital affiliated to Xiamen University from
June 2019 to June 2021 were selected as the research object. The patients were randomly divided into the local
anesthesia group (control group) and the local anesthesia combined with intravenous anesthesia of
dexmedetomidine injection during operation group (observation group) by using random number table method.
The efficacy, complications, S100-β and NIHSS scores were compared between the two groups. Results: The
incidence of blood pressure fluctuation, puncture to recanalization time (PRT), radiation exposure time, and
thrombectomy times in the observation group were significantly lower than those in the control group (all P<
0.05), and the first recanalization rate was higher than that in the control group (P<0.05). There was no
significant difference in SpO2, pulmonary infection, mortality, total recanalization rate and incidence of SICH
between the two groups (P>0.05). There was no significant difference in NIHSS score between the two groups
before and after surgery (P>0.05), but the proportion of patients with a decrease of NIHSS score ≥8 points in
observation group was significantly higher than that in control group (P<0.05). There was no significant
difference in S100-β level between the two groups before surgery (P>0.05), but S100-β level in observation
group was lower than that in control group at 7 days after surgery (P<0.05). Conclusion: The application of
dexmedetomidine in EVT for acute anterior circulation ischemic stroke can improve the curative effect and
reduce nerve function damage, which has the advantages of high efficiency and safety. |
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