Department of Anesthesiology, Xingtai People's Hospital, Xingtai, Hebei, China.
Biomed Res Int. 2022 Jul 15;2022:4008941. doi: 10.1155/2022/4008941. eCollection 2022.
Dexmedetomidine (Dex) is an alpha-2 agonist used for sedation during various procedures. Dex activates 2-adrenoceptors, and causes the decrease of sympathetic tone, with attenuation of the neuroendocrine and hemodynamic responses to anesthesia and surgery; it reduces anesthetic and opioid requirements; and causes sedation and analgesia.
it was to compare the perioperative effects of different doses of Dex at different timing in patients using Dex during the perioperative period adopting a medical data classification algorithm based on optimized semi-supervised collaborative training (Tri-training).
495 patients requiring surgical treatment in Xingtai People's Hospital were randomly selected as the study subjects. The patients were divided into group A (used before induction), group B (used during induction), and group C (used after induction) according to different induction timing, with 165 cases in each group. Then, groups A, B, and C were divided into groups A1, B1, and C1 (0.4 g/(kg·h) rate), groups A2, B2, and C2 (0.6 g/(kg·h) rate), and groups A3, B3, and C3 (0.8 g/(kg·h) rate) according to the dose used, with 55 cases in each group. Intraoperative anesthesia and postoperative adverse reactions were compared among the 9 groups.
the similarity between the Tri-training algorithm optimized by Naive Bayes (NB) classification algorithm and the actual classification (93.49%) was clearly higher than that by decision tree (DT) and K-nearest neighbor (kNN) classification algorithm (76.21%, 74.31%); heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) values decreased obviously after Dex used in groups B1, C1, B2, C2, B3, and C3 (), but did not change significantly in groups A1, A2, and A3 (); the proportion of patients with satisfactory Ramsay score in group A3 was distinctly superior than that in groups A1, A2, B1, B2, B3, C1, C2, and C3 (); the incidence of adverse reactions in group A3 was significantly inferior than that in groups A1, A2, B1, B2, B3, C1, C2, and C3 ().
the optimization effect of NB classification algorithm was the best, and the injection of Dex at the injection rate of 0.8 g/(kg·h) before induction of anesthesia could apparently improve the fluctuation of HR, SBP, and DBP during perioperative period, and effectively reduce the occurrence of adverse reactions in patients, with better sedative effect on patients.
右美托咪定(Dex)是一种用于各种程序镇静的 α-2 激动剂。 Dex 激活 2-肾上腺素能受体,导致交感神经张力降低,麻醉和手术的神经内分泌和血液动力学反应减弱;它减少了麻醉和阿片类药物的需求;并产生镇静和镇痛作用。
比较不同剂量 Dex 在不同时间点在围手术期使用的围手术期效果,采用基于优化半监督协作训练(Tri-training)的医学数据分类算法。
随机选择 495 名需要在邢台市人民医院接受手术治疗的患者作为研究对象。根据不同的诱导时机,将患者分为 A 组(诱导前使用)、B 组(诱导时使用)和 C 组(诱导后使用),每组 165 例。然后,A、B 和 C 组根据使用剂量分为 A1、B1 和 C1(0.4μg/(kg·h))、A2、B2 和 C2(0.6μg/(kg·h))和 A3、B3 和 C3(0.8μg/(kg·h)),每组 55 例。比较 9 组患者的术中麻醉和术后不良反应。
基于朴素贝叶斯(NB)分类算法优化的 Tri-training 算法与实际分类(93.49%)的相似度明显高于决策树(DT)和 K-最近邻(kNN)分类算法(76.21%,74.31%);B1、C1、B2、C2、B3 和 C3 组使用 Dex 后心率(HR)、收缩压(SBP)和舒张压(DBP)明显下降(),但 A1、A2 和 A3 组无明显变化();A3 组 Ramsay 评分满意的患者比例明显优于 A1、A2、B1、B2、B3、C1、C2 和 C3 组();A3 组不良反应发生率明显低于 A1、A2、B1、B2、B3、C1、C2 和 C3 组()。
NB 分类算法的优化效果最好,麻醉诱导前以 0.8μg/(kg·h)的速度注射 Dex 可明显改善围手术期 HR、SBP 和 DBP 的波动,有效降低患者不良反应的发生,对患者具有更好的镇静作用。