右美托咪定在术后高血压性脑出血患者的镇静和脑保护方面优于咪达唑仑：一项回顾性研究。
Dexmedetomidine is superior to midazolam for sedation and cerebral protection in postoperative hypertensive intracerebral hemorrhage patients: a retrospective study.
作者信息
Gong Weiyi, Zhang Shuguang, Li Xiaoliang, Shi Lei
机构信息
Department of Neurosurgery, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, P.R. China.
出版信息
J Int Med Res. 2020 Sep;48(9):300060520957554. doi: 10.1177/0300060520957554.
OBJECTIVE
Dexmedetomidine has a good sedative effect and does not affect the judgment of the patient's consciousness level. However, its effectiveness for sedation and cerebral protection after craniotomy in hypertensive intracerebral hemorrhage (HICH) patients is unknown.
METHODS
A retrospective study of 164 postoperative HICH patients who underwent sedation with dexmedetomidine or midazolam was conducted. The Ramsay sedation score, mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO), and respiratory rate were measured at the indicated time points. Human soluble protein-100β (S-100β) and neuron-specific enolase (NSE) levels were also compared between the two groups.
RESULTS
Dexmedetomidine treatment showed a significantly better effect than midazolam on decreasing the frequency of apparent agitation. The MAP and HR, but not the SpO were significantly decreased and lower than those in midazolam group. Detection of plasma S-100β and NSE proteins revealed a significant decrease in the dexmedetomidine group compared with the midazolam group. The 6-month follow-up evaluation indicated a significantly better prognosis of postoperative HICH patients treated with dexmedetomidine than for those treated with midazolam.
CONCLUSIONS
Dexmedetomidine is effective for sedation in postoperative HICH patients and may be beneficial for their outcome.
目的
右美托咪定具有良好的镇静效果，且不影响对患者意识水平的判断。然而，其在高血压脑出血（HICH）患者开颅术后镇静及脑保护方面的有效性尚不清楚。
方法
对164例接受右美托咪定或咪达唑仑镇静的HICH术后患者进行回顾性研究。在指定时间点测量 Ramsay 镇静评分、平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO）和呼吸频率。还比较了两组患者的人可溶性蛋白-100β（S-100β）和神经元特异性烯醇化酶（NSE）水平。
结果
在减少明显躁动频率方面，右美托咪定治疗效果明显优于咪达唑仑。MAP和HR显著降低，且低于咪达唑仑组，但SpO无显著差异。血浆S-100β和NSE蛋白检测显示，与咪达唑仑组相比，右美托咪定组显著降低。6个月的随访评估表明，接受右美托咪定治疗的HICH术后患者预后明显优于接受咪达唑仑治疗的患者。
结论
右美托咪定对HICH术后患者镇静有效，可能对其预后有益。
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