右美托咪定对重度颅脑损伤患者胃电图影响的研究
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摘要
目的观察重度颅脑损伤患者应用右美托咪定后对胃电图的影响。方法选择2017年1-12月我院重症医学科收治的重度颅脑损伤患者60例,随机分为治疗组(30例)及对照组(30例),10例健康志愿者作为正常对照组不给予任何治疗。对照组给予常规综合治疗,治疗组在此基础上给予右美托咪定镇静。入院及治疗24 h后进行胃电图检查。结果治疗24 h后,治疗组与对照组胃电功率VP-P(uv)分别为169. 1±81. 1和463. 4±97. 7,胃电节律紊乱百分比分别为14. 3%±5. 2%和63. 5%±21. 6%,偶联百分比分别为96. 2%±3. 8%和79. 1%±11. 2%。治疗组胃电功率、胃电节律紊乱百分比、偶联百分比均优于对照组(P <0. 01)。结论右美托咪定对重症颅脑损伤患者的胃电主功率及胃电节律紊乱百分比、偶联百分比均有明显的影响。
Objective To investigate the influence of dexmedetomidine on electrogastrography( EGG) in patients with severe traumatic brain injury.Methods Totally 60 patients with severe traumatic brain injury admitted to Intensive Care Unit of our hospital from January to December in 2017 were randomly divided into experiment group( n=30) and control group( n=30).Ten healthy volunteers served as normal controls.Control group was given routine comprehensive treatment,and experiment group was given dexmedetomidine on the basis of treatment for control group.Electrogastrography( EGG) was examined before and after 24 h of treatment.Results After 24 h of treatment,gastric electrical power of experiment group and control group( uv) was 169.1 ± 81.1 and 463.4 ± 97.7 respectively.The percentage of electrogastric dysrhythmia of experiment group and control group was 14.3% ± 5.2% and 63.5% ±21.6% respectively.Power distribution of experimental group and control group was 96.2% ± 3.8% and 79.1% ±11.2% respectively.The gastric electrical power,the percentage of electrogastric dysrhythmia and power distribution of experimental group were significantly improved compared with those of control group( P<0.01).Conclusion Dexmedetomidine treatment has significant influence on gastric electrical power,the percentage of electrogastric dysrhythmia and power distribution in patients with severe traumatic brain injury.
Objective To investigate the influence of dexmedetomidine on electrogastrography( EGG) in patients with severe traumatic brain injury.Methods Totally 60 patients with severe traumatic brain injury admitted to Intensive Care Unit of our hospital from January to December in 2017 were randomly divided into experiment group( n=30) and control group( n=30).Ten healthy volunteers served as normal controls.Control group was given routine comprehensive treatment,and experiment group was given dexmedetomidine on the basis of treatment for control group.Electrogastrography( EGG) was examined before and after 24 h of treatment.Results After 24 h of treatment,gastric electrical power of experiment group and control group( uv) was 169.1 ± 81.1 and 463.4 ± 97.7 respectively.The percentage of electrogastric dysrhythmia of experiment group and control group was 14.3% ± 5.2% and 63.5% ±21.6% respectively.Power distribution of experimental group and control group was 96.2% ± 3.8% and 79.1% ±11.2% respectively.The gastric electrical power,the percentage of electrogastric dysrhythmia and power distribution of experimental group were significantly improved compared with those of control group( P<0.01).Conclusion Dexmedetomidine treatment has significant influence on gastric electrical power,the percentage of electrogastric dysrhythmia and power distribution in patients with severe traumatic brain injury.
引文
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[5]王玉玺,徐昌顺,蔡铁良,等.右美托咪定与丙泊酚在脑功能区术中唤醒麻醉中对应激反应的影响[J].中国医药,2016,11(11):1644-1648.
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[7]魏红芳,陈永学,李书河,等.右美托咪定对急性颅脑损伤患者围术期炎性反应的影响[J].中华麻醉学杂志,2012,32(10):1249-1251.
[8]Hao J,Luo JS,Weng Q,et al.Effects of dexmedetomidine on sedation andβ-endorphin in traumatic brain injury:a comparative study with propofol[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2013,25(6):373-376.
[9]Aryan HE,Box KW,Ibrahim D,et al.Safety and efficacy of dexmedetomidine in neurosurgical patients[J].Brain Inj,2006,20(8):791-798.
[10]Ma D,Hossain M,Rajakumaraswamy N,et al.Dexmedetomidine produces its neuroprotective effect via the alpha 2A-adrenoceptor subtype[J].Eur J Pharmacol,2004,502(1-2):87-97.
[11]Thor PJ,Gosciński I,Kolasińska-Kloch W,et al.Gastric myoelectric activity in patients with closed head brain injury[J].M ed Sci M onit,2003,9(9):CR392-CR395.
[12]Thor PJ,Madroszkiewicz D,Moskaa M,et al.Gastric myoelectric activity disturbance in patients with traumatic lesions of the brain stem[J].Neurol Neurochir Pol,2003,37(5):1037-1045.
[13]O'Grady G,Wang TH,Du P,et al.Recent progress in gastric arrhythmia:pathophysiology,clinical significance and future horizons[J].Clin Exp Pharmacol Physiol,2014,41(10):854-862.
[14]Lim HC,Lee SI,Chen JD,et al.Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia[J].World J Gastroenterol,2012,18(41):5948-5956.
[2]柯美云.胃电图检查及其评判标准(草案)[J].中华消化杂志,2000,20(6):401.
[3]陈冬梅,闫建平.右美托咪定复合丙泊酚和瑞芬太尼用于脑动脉瘤夹闭术患者麻醉的效果分析[J].中国医药,2016,11(1):38-41.
[4]郭余大,戴寒英,陈立科,等.不同剂量右美托咪定对SEP联合MEP监测神经外科手术患者的影响[J].实用医学杂志,2017,33(10):1669-1673.
[5]王玉玺,徐昌顺,蔡铁良,等.右美托咪定与丙泊酚在脑功能区术中唤醒麻醉中对应激反应的影响[J].中国医药,2016,11(11):1644-1648.
[6]梅弘勋,熊蔚,韩如泉.右美托咪定在颅脑手术麻醉中的应用[J].中国医药,2017,12(3):370-374.
[7]魏红芳,陈永学,李书河,等.右美托咪定对急性颅脑损伤患者围术期炎性反应的影响[J].中华麻醉学杂志,2012,32(10):1249-1251.
[8]Hao J,Luo JS,Weng Q,et al.Effects of dexmedetomidine on sedation andβ-endorphin in traumatic brain injury:a comparative study with propofol[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2013,25(6):373-376.
[9]Aryan HE,Box KW,Ibrahim D,et al.Safety and efficacy of dexmedetomidine in neurosurgical patients[J].Brain Inj,2006,20(8):791-798.
[10]Ma D,Hossain M,Rajakumaraswamy N,et al.Dexmedetomidine produces its neuroprotective effect via the alpha 2A-adrenoceptor subtype[J].Eur J Pharmacol,2004,502(1-2):87-97.
[11]Thor PJ,Gosciński I,Kolasińska-Kloch W,et al.Gastric myoelectric activity in patients with closed head brain injury[J].M ed Sci M onit,2003,9(9):CR392-CR395.
[12]Thor PJ,Madroszkiewicz D,Moskaa M,et al.Gastric myoelectric activity disturbance in patients with traumatic lesions of the brain stem[J].Neurol Neurochir Pol,2003,37(5):1037-1045.
[13]O'Grady G,Wang TH,Du P,et al.Recent progress in gastric arrhythmia:pathophysiology,clinical significance and future horizons[J].Clin Exp Pharmacol Physiol,2014,41(10):854-862.
[14]Lim HC,Lee SI,Chen JD,et al.Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia[J].World J Gastroenterol,2012,18(41):5948-5956.