Abstract：Objective: To study the effects of dexmedetomidine and propofol in patients with liver and kidney function, blood gas analysis of craniocerebral injury. Methods: 80 cases of craniocerebral injury admitted in our hospital from November 2012 to November 2017 (40 cases of normal liver and kidney function, 40 cases of abnormal liver and kidney function) were retrospectively studied. According to the random number table method, 40 cases of patients with normal liver function were divided into group A and group B, each of 20 cases; 40 cases of liver and kidney dysfunction were divided into group C and group D, each of 20 cases. Group A and group C were anesthetized with dexmedetomidine combined with propofol, and group B and D were used to induce anesthesia by propofol alone. The general data of all patients (gender, age, BMI, ASA score, and operation time) were counted; The liver function (AST, ALT), renal function (serum creatinine, blood urea nitrogen) and blood gas analysis (PaO2 and PaCO2) were detected before operation (T1), 12h (T2) after operation and 24h (T3) after operation. Results: There was no significant changes of AST and ALT in 12h and 24h after operation (P > 0.05). There was no significant difference in AST and ALT between group A and group B, group C and group D at the same time point (P > 0.05). 12h and 24h after operation, the BUN and Scr were significantly increased (P < 0.05). The blood urea nitrogen and serum creatinine levels in the group A were significantly lower than those in the group B (P < 0.05), and the group C was significantly lower than that in the group D (P < 0.05). After operation, all the patients in each group decreased significantly (P < 0.05) and PaCO2 significantly increased (P < 0.05). At the same time point, the PaO2 value of group A was higher than that of group B (P < 0.05), and the C group was significantly higher than that of group D (P < 0.05), PaCO2 value in group A was significantly lower than that of group B (P < 0.05). Conclusion: Dexmedetomidine combined with propofol can improve renal function and blood gas analysis in patients with craniocerebral injury, but has no obvious protective effect on liver and little effect on liver function.
曹桂珍, 殷乐, 陈建均. 肾癌患者右美托咪定复合丙泊酚对颅脑损伤患者肝肾功能血气分析的影响[J]. 河北医学, 2018, 24(1): 38-43.
CAO Guizhen, YIN Le, CHEN Jianjun. Effects of Dexmedetomidine Combined with Propofol on Liver and Kidney Function and Blood Gas Analysis in Patients with Brain Injury. HeBei Med, 2018, 24(1): 38-43.
[1] 邓晰明,邹琪,段立彬,等.右美托咪定对重型颅脑外伤术后脑氧代谢的影响[J].中山大学学报(医学科学版),2016,37(4):630~636. [2] 唐泽,陶武,王念,李丹,蒋世双,苟小红,冉昆足.右美托咪定在颅脑损伤患者术后24h内持续镇静的有效性及安全性[J].重庆医学,2015,44(11):1533~1534. [3] 王洪涛,袁林辉,曹建,胡衍辉,徐国海.不同麻醉药物在老年颅脑损伤患者中的应用价值[J].中国老年学杂志,2014,(23):6666~6667. [4] 卓九五,刘存明,殷国平.右美托咪定对肝炎肝硬化患者围术期应激反应和免疫功能的影响[J].临床麻醉学杂志,2016,32(07):645~649. [5] Tang Q, Wu X, Weng W, et al. The preventive effect of dexmedetomidine on paroxysmal sympathetic hyperactivity in severe traumatic brain injury patients who have undergone surgery: a retrospective study[J].Peerj, 2017, 5(5):e2986. [6] Alam A, Suen KC, Hana Z, Sanders RD, Maze M, Ma D.Neuroprotection and neurotoxicity in the developing brain: an update on the effects of dexmedetomidine and xenon[J].Neurotoxicol Teratol,2017,60:102~116. [7] Endesfelder S, Makki H, Von Haefen C, Spies CD, Bührer C, Sifringer M.Neuroprotective effects of dexmedetomidine against hyperoxia-induced injury in the developing rat brain[J].PLoS One,2017,12(2):e0171498. [8] Humble SS, Wilson LD, Leath TC, Marshall MD, Sun DZ, Pandharipande PP, Patel MB.ICU sedation with dexmedetomidine after severe traumatic brain injury[J].Brain Inj,2016,30(10):1266~1270. [9] Pajoumand M, Kufera JA, Bonds BW, Devabhakthuni S, Boswell S, Hesselton K, Scalea TM, Stein DM.Dexmedetomidine as an adjunct for sedation in patients with traumatic brain injury[J].Trauma Acute Care Surg,2016,81(2):345~351. [10] Balkanay OO, Goksedef D, Omeroglu SN, Ipek G.The dose-related effects of dexmedetomidine on renal functions and serum neutrophil gelatinase-associated lipocalin values after coronary artery bypass grafting: a randomized, triple-blind, placebo-controlled study[J].Interact Cardiovasc Thorac Surg,2015,20(2):209~214. [11] 徐守才,赵海芳.右美托咪定的器官保护作用[J].上海医学,2014,(10):898~901. [12] Liu Z, Wang Y, Wang Y, Ning Q, Zhang Y, Gong C, Zhao W, Jing G, Wang Q.Dexmedetomidine attenuates inflammatory reaction in the lung tissues of septic mice by activating cholinergic anti-inflammatory pathway[J].Int Immunopharmacol,2016,35:210~216. [13] 潘婧儒,池信锦,高婉菱,等.肝功能不同患者靶控输注丙泊酚的药效反应[J].中华肝脏外科手术学电子杂志,2015,4(5):301~305.
2018, Vol. 24 
冀公网安备13080202000677号