摘要
目的观察多巴胺阶段性输注对缺血性脑血管病介入治疗患者的影响。方法选择拟在全身麻醉下行血管内介入治疗的缺血性脑血管病患者100例,性别不限,年龄35~80岁,体重40~100 kg,体质指数(BMI)18~25 kg/m^2,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级。随机分为两组,A组(n=50)患者于麻醉诱导开始时静脉持续输注多巴胺8μg·kg^(-1)·min^(-1),B组(n=50)患者同一时刻泵注等量生理盐水作空白对照;两组患者分别于支架植入成功时停止泵注多巴胺或生理盐水,控制血压于基础水平低值,以防止脑血管再通后缺血-再灌注损伤。两组患者均接受相同药物作麻醉诱导、麻醉维持,接受相同补液速度,尽量减少引起围术期循环波动的混杂因素。观察并记录患者入手术室时、麻醉过程及苏醒期心率、平均动脉压变化及苏醒时间、血管活性药物使用情况。结果 A组患者血压较B组平稳,额外使用多巴胺次数较少;A组患者麻醉苏醒期呼吸恢复时间、呼之睁眼时间较B组时间短,差异均有统计学意义(P<0.05)。结论缺血性脑血管病患者支架植入前接受多巴胺输注,可更好地维持循环指标于目标水平,保证良好脑灌注,并可缩短患者苏醒所需时间。
Objective To investigate the effects of staged infusion of dopamine on the patients with ischemic cerebrovascular receiving endovascular treatment under general anesthesia. Methods A total of 100 patients with ischemic eerebrovascular disease, who were planned to receive endovascular treatment under general anesthesia, were enrolled in this study. With no gender limitation, the included patients were 35-80 years old, with body weight being 40-100 kg and body mass index （BMI） being 18-25 kg/m^2 ; all the patients belonged to America Anesthesiologists Association （ASA） Grade I-III. The patients were randomly divided into A （study group, n= 50） and group B （control group, n= 50）. Patients in group A received continuous intravenous infusion of dopamine 8 g/kg rain i at the beginning of anesthesia induction, while patients in group B received continuous intravenous infusion of the same dose saline at the same time. The pumping of dopamine or normal saline was stopped in both groups when stent implantation was successfully accomplished, and tire blood pressure was maintained at the low level of the baseline range so as to prevent the occurrence of high peffusion injury due to recanalization of cerebral blood vessels. In all patients of both groups, the same drug was employed for anesthesia induction as well as for anesthesia maintenance, and the same fluid infusion rate was adopted, and the confounding factors that might cause circulation fluctuations in perioperative period were eliminated as far as possible. The heart rate and the mean arterial pressure were recorded at the time when the patient was sent into the operation room, during the period of anesthesia and at waking up from anesthesia; the time of awakening and the use of vasoactive drugs were also documented. Results The mean arterial pressure in patients of group A was more stable than that in patients of group B ; and the use number of additional single injection of dopamine in group A was lower than that in group B. The breathing recovery time from anesthesia and the time of eye-opening to calling in patients of group A were shorter than those in patients of group B ; the differences were statistically significant （P 〈 0. 05 ）. Conclusion Dopamine infusion used before stent implantation in patients with ischemie cerebrovascular disease can well maintain the circulation at the target level and ensure a satisfactory brain peffusion, and it can shorten the time of awakening as well.
出处
《介入放射学杂志》
CSCD
北大核心
2016年第8期654-657,共4页
Journal of Interventional Radiology
关键词
多巴胺
缺血性脑血管病
神经介入治疗
脑灌注
dopamine
isehemic cerebrovascular disease
neurointerventional therapy
cerebral perfusion
