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围手术期同时使用右美托咪定(DEX)对颅脑介入手术后患者肾功能的影响。

The effect of the concurrent use of Dexmedetomidine (DEX) during the perioperative period on the renal function of patients following craniocerebral interventional surgery.

作者信息

Qian Lu, Hu Nianqiang, Yu Yijin

机构信息

Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.

出版信息

Int J Neurosci. 2025 Aug;135(8):851-862. doi: 10.1080/00207454.2024.2335530. Epub 2024 Apr 1.

DOI:10.1080/00207454.2024.2335530
PMID:38526065
Abstract

BACKGROUND

Craniocerebral interventional surgery is a common and essential treatment for cerebrovascular diseases. Despite continuous progress in interventional diagnosis and treatment technology, there is no effective method to alleviate contrast-induced kidney injuries. In this retrospective cohort study, we investigated the effect of the concurrent use of Dexmedetomidine (DEX) during the perioperative period on the renal function of patients following craniocerebral interventional surgery.

METHODS

We identified 228 cases of patients underwent craniocerebral interventional surgery from January 2018 to March 2022. Patients who used DEX during general anesthesia were in the DEX group (DEX group) or that did not use dexmedetomidine as the control group (CON group). The markers of kidney injury were recorded before and within 48 h after surgery.

RESULTS

Compared with CON group, the urea nitrogen (BUN) of the DEX group decreased significantly on the first day and the second day after surgery ( < 0.05). The serum cystatin-C and the blood urea nitrogen/creatinine ratio (BUN/Cr) was significantly lower than that in CON group on the second day ( < 0.05). The urine output in the DEX group increased significantly, and the mean arterial pressure (MAP) was higher than the CON group ( < 0.01). There was no difference in postoperative complications, ICU stay time and hospitalization time between the two groups.

CONCLUSION

The combined use of dexmedetomidine in general anesthesia for craniocerebral interventional surgery can reduce BUN levels within 48 h after surgery, significantly increase intraoperative urine volume, maintain intraoperative circulation stability.

摘要

背景

颅脑介入手术是治疗脑血管疾病常见且重要的手段。尽管介入诊断和治疗技术不断进步,但尚无有效方法减轻对比剂肾病。在这项回顾性队列研究中,我们调查了围手术期同时使用右美托咪定(DEX)对颅脑介入手术后患者肾功能的影响。

方法

我们纳入了2018年1月至2022年3月期间接受颅脑介入手术的228例患者。全身麻醉期间使用DEX的患者为DEX组,未使用右美托咪定的患者为对照组(CON组)。记录术前及术后48小时内的肾损伤标志物。

结果

与CON组相比,DEX组术后第一天和第二天的尿素氮(BUN)显著降低(<0.05)。第二天血清胱抑素-C和血尿素氮/肌酐比值(BUN/Cr)显著低于CON组(<0.05)。DEX组尿量显著增加,平均动脉压(MAP)高于CON组(<0.01)。两组术后并发症、ICU住院时间和住院时间无差异。

结论

在颅脑介入手术全身麻醉中联合使用右美托咪定可降低术后48小时内BUN水平,显著增加术中尿量,维持术中循环稳定。

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