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| 陈良义,陈星宇,张建平,翁磊华(通讯作者)厦门大学附属中山医院神经内科 福建 厦门 361004 |
| Efficacy and safety of intravenous anesthesia with dexmedetomidine in endovascular treatment of acute anterior circulation occlusion stroke |
| 投稿时间：2023-11-02 修订日期：2023-11-02 |
| 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 S100B蛋白 疗效 安全性 |
| 英文关键词: dexmedetomidine acute anterior circulation obliteration stroke endovascular therapy S100B protein efficacy safety |
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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)中应用疗效。方法 选择2019年6月-2021年6月厦门大学附属中山医院诊治的116例行EVT治疗的急性前循环缺血性卒中患者为研究对象,采用随机数字表法分为股动脉穿刺局部麻醉(对照组)和股动脉局麻基础上联合术中右美托咪定注射液静脉麻醉(观察组)。比较两组患者疗效、并发症、S100B及NIHSS评分差异。结果 观察组患者血压波动发生率、PTR、受线时间、取栓次数及SICH发生率显著低于对照组,首次再通率、总再通率显著高于对照组患者,差异有统计学意义(P<0.05)。两组患者在SpO2、肺部感染及死亡率方面的差异无统计学意义(P>0.05)。 观察组和对照组患者术前S100B及NIHSS评分均无统计学差异(P>0.05)；两组患者术后7d的S100B及NIHSS评分均显著低于治疗前(P<0.05)。观察组患者术后7d的S100B及NIHSS评分显著低于对照组(P<0.05),NIHSS评分下降≥8分比例显著高于对照组(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: |
| Objective To explore the efficacy of intravenous anesthesia with dexmedetomidine in endovascular therapy (EVT) for acute anterior circulation obliterative stroke. Methods From June 2019 to June 2021, 116 patients with acute anterior circulation ischemic stroke who underwent EVT treatment in Zhongshan Hospital Affiliated to Xiamen University were selected as the research subjects. They were divided into femoral artery puncture and local anesthesia (control group) by random number table method. group) and femoral artery local anesthesia combined with intraoperative dexmedetomidine injection intravenous anesthesia (observation group). The efficacy, complications, S100B and NIHSS scores were compared between the two groups. Results The incidence of blood pressure fluctuation, PTR, line receiving time, times of thrombectomy and incidence of SICH in the observation group were significantly lower than those in the control group, and the first recanalization rate and total recanalization rate were significantly higher than those in the control group, the difference was statistically significant (P<0.05). There was no significant difference in SpO2, pulmonary infection and mortality between the two groups (P>0.05). There were no significant differences in the preoperative S100B and NIHSS scores between the observation group and the control group (P>0.05); the S100B and NIHSS scores of the two groups at 7 days after operation were significantly lower than those before treatment (P<0.05). The S100B and NIHSS scores of the observation group at 7 days after operation were significantly lower than those of the control group (P<0.05), and the proportion of NIHSS score decrease ≥ 8 points was significantly higher than that of the control group (P<0.05). Conclusion The application of dexmedetomidine in EVT of acute anterior circulation obliteration stroke can improve the curative effect and reduce neurological damage, and has the advantages of high efficiency and safety. |
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