麻醉诱导前负荷剂量右美托咪定静注+术中持续泵注对老年高血压合并冠心病择期非心脏手术患者心肌损伤标志物及应激反应指标水平的影响

目的 分析麻醉诱导前负荷剂量右美托咪定静注+术中持续泵注对老年高血压合并冠心病择期非心脏手术患者心肌损伤标志物及应激反应指标水平的影响.方法 选取2019年5月至2021年5月收治的86例老年高血压合并冠心病择期非心脏手术患者,按电脑盲选法将其分为对照组(n=43,麻醉诱导前负荷剂量生理盐水静注+术中持续泵注)与研究组...

Effects of anesthesia induction preload dose dexmedetomidine intravenous injection+intraoperative continuous pump injection on myocardial injury markers and stress response indexes levels in elderly patients with hypertension complicated with coronary heart disease undergoing elective non-cardiac surgery

Objective To analyze the effects of anesthesia induction preload dose dexmedetomidine intravenous injection+intraoperative continuous pump injection on myocardial injury markers and stress response indexes levels in elderly patients with hypertension complicated with coronary heart disease undergoing elective non-cardiac surgery.Methods A total of 86 elderly patients with hypertension complicated with coronary heart disease undergoing elective non-cardiac surgery admitted from May 2019 to May 2021 were selected and divided into control group(n=43,anesthesia induction preload dose normal saline intravenous injection+intraoperative continuous pump injection)and study group(n=43,anesthesia induction preload dose dexmedetomidine intravenous injection+intraoperative continuous pump injection)by computer blind selection method.The hemodynamic indexes,myocardial injury markers,stress response indexes,immune function indexes and cognitive function of the two groups were compared,and the adverse reactions of the two groups were counted.Results At the beginning of operation(T₂),30 min of operation(T₃)and extubation(T₄),the heart rate(HR),diastolic blood pressure(DBP)and systolic blood pressure(SBP)in the study group were lower than those in the control group(P<0.05).At 24 h after operation,the levels of creatine kinase isozyme(CK-MB),cardiac troponin I(cTnI),glycogen phosphorylase-BB(GP-BB),interleukin-6(IL-6),norepinephrine(NE)and cortisol(Cor)in the study group were significantly lower than those in the control group(P<0.05).At 24 h after operation,CD4⁺and CD4⁺/CD8⁺in the study group were higher than those in the control group,and CD8⁺was lower than that in the control group(P<0.05).At 24 h after operation,the levels of neuron specific enolase(NSE)and central nerve specific protein(S100β)in the study group were lower than those in the control group,MMSE score was higher than that in the control group(P<0.05).The total incidence of adverse reactions in the study group was significantly lower than that in the control group(P<0.05).Conclusion Anesthesia induction preload dose dexmedetomidine intravenous injection+intraoperative continuous pump injection is effective in elderly hypertension complicated with coronary heart disease,which can be further popularized in clinic.