發(fā)布時(shí)間：2018-10-05 16:50

【摘要】：目的探討右美托咪定對(duì)心肺轉(zhuǎn)流(CPB)下行冠狀動(dòng)脈旁路移植術(shù)(CABG)患者心臟同步化運(yùn)動(dòng)的影響。方法擇期CPB下行CABG患者24例,年齡43~75歲,體表面積1.53~2.00m2,ASAⅡ或Ⅲ級(jí),心功能Ⅱ或Ⅲ級(jí)。采用隨機(jī)數(shù)字表法分為兩組:右美托咪定組(D組)和對(duì)照組(C組),每組12例。兩組術(shù)中麻醉維持均采用全憑靜脈麻醉,D組于主動(dòng)脈開(kāi)放后經(jīng)微量注射泵靜注右美托咪定負(fù)荷劑量0.5μg/kg(10min內(nèi)注射完),然后以0.5μg·kg-1·h-1維持給藥至術(shù)畢,C組靜注等量生理鹽水。分別于開(kāi)胸前(T1)和CPB停機(jī)后30min(T2)、60min(T3)記錄血流動(dòng)力學(xué)指標(biāo):HR、MAP、CVP、心臟指數(shù)(CI),左右心室收縮功能指標(biāo):左室射血分?jǐn)?shù)(LVEF)、右室射血分?jǐn)?shù)(RVEF)和心臟同步性參數(shù):PR間期、QRS時(shí)限、室間機(jī)械延遲(IVMD)。結(jié)果與T1時(shí)比較,T2、T3時(shí)兩組HR明顯增快、CI明顯升高(P0.01);與C組比較,D組T2、T3時(shí)PR間期明顯延長(zhǎng)(P0.05)。兩組間QRS時(shí)限及IVMD差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 CPB下冠狀動(dòng)脈旁路移植術(shù)患者,右美托咪定負(fù)荷劑量0.5μg/kg后以0.5μg·kg-1·h-1維持能夠延長(zhǎng)PR間期,影響房室間同步化運(yùn)動(dòng),但對(duì)左右心室間電機(jī)械同步化運(yùn)動(dòng)無(wú)明顯影響。
[Abstract]:Objective to investigate the effect of dexmetomidine on cardiac synchronization in patients with (CABG) undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods Twenty-four patients (age 4375 years) with CABG undergoing elective CPB were enrolled in this study. The body surface area was 1.532.00m2ASA 鈪，

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