依托咪酯联合右美托咪定对高血压基底节区脑出血患者脑糖氧代谢和氧化应激的影响

摘要 目的：观察依托咪酯联合右美托咪定对高血压基底节区脑出血患者脑糖氧代谢和氧化应激的影响。方法：纳入2020年1月-2022年12月期间我院收治的90例高血压基底节区脑出血患者，采用随机数字表法将患者分为对照组和研究组，各为45例。对照组患者接受依托咪酯乳状注射液麻醉，研究组患者接受依托咪酯乳状注射液联合右美托咪定注射液麻醉。对比两组血流动力学[心率（HR）、平均动脉压（MAP）]、糖氧代谢指标[氧饱和度（SjvO₂）、脑氧摄取率（CEO₂）、脑动静脉氧差（AVDO₂）]、氧化应激指标[丙二醛（MDA）和超氧化物歧化酶（SOD）]和不良反应。结果：麻醉诱导后5 min（T1）~手术完毕时（T4）时间点，研究组心率（HR）、平均动脉压（MAP）低于对照组（P<0.05）。T4时间点，研究组SjvO₂高于对照组，CEO₂、AVDO₂低于对照组（P<0.05）。T4时间点，研究组SOD高于对照组，MDA低于对照组（P<0.05）。两组不良反应总发生率对比未见差异（P>0.05）。结论：依托咪酯联合右美托咪定可更好维持机体血流动力学，改善脑糖氧代谢，减轻氧化应激，对高血压基底节区脑出血患者发挥出良好的麻醉效果。

Effects of Etomidate Combined with Dexmedetomidine on Cerebral Glucose and Oxygen Metabolism and Oxidative Stress in Patients with Hypertensive Basal Ganglia Intracerebral Hemorrhage

ABSTRACT Objective: To observe the effects of Etomidate combined with dexmedetomidine on cerebral glucose and oxygen metabolism and oxidative stress in patients with hypertensive basal ganglia intracerebral hemorrhage. Methods: 90 patients with hypertensive basal ganglia cerebral hemorrhage admitted between January 2020 and December 2022 were randomly divided into a control group and a study group using a random number table method, with 45 patients in each group. The patients in the control group received Etomidate anesthesia, and the patients in the study group received Etomidate combined with dexmedetomidine anesthesia. The hemodynamics [heart rate (HR), Mean arterial pressure (MAP)], glucose and oxygen metabolism indicators [oxygen saturation (SjvO₂), cerebral oxygen utilization rate (CEO₂), oxygen difference between cerebral artery and cerebral vein (AVDO₂)], oxidative stress indicators [Malondialdehyde (MDA) and Superoxide dismutase (SOD)] and adverse reactions were compared between the two groups. Results: The heart rate (HR) and Mean arterial pressure (MAP) in the study group were lower than those in the control group from 5 minutes (T1) to the end of surgery (T4) after anesthesia induction (P<0.05). At the T4 time point, the oxygen saturation (SjvO₂) of the study group was higher than that of the control group, while the cerebral oxygen utilization rate (CEO₂) and the oxygen difference between cerebral arteries and veins (AVDO₂) were lower than those of the control group (P<0.05). At T4 time point, Superoxide dismutase (SOD) in the study group was higher than that in the control group, and Malondialdehyde (MDA) was lower than that in the control group (P<0.05). There was no difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Etomidate combined with dexmedetomidine in the treatment of hypertensive basal ganglia intracerebral hemorrhage can better maintain body hemodynamics, improve cerebral glucose and oxygen metabolism, reduce oxidative stress, and play a good anesthetic effect.