2021 年第 7 期 第 16 卷

盐酸右美托咪定对非体外循环冠状动脉旁路移植术患者肾功能的影响

Effect of dexmedetomidine hydrochloride on renal function in patients undergoing off-pump coronary artery bypass grafting

作者：贾兆晋刘明霞孙鹏李秀华陈晓伟窦学斌施丞南

英文作者：Jia Zhaojin Liu Mingxia Sun Peng Li Xiuhua Chen Xiaowei Dou Xuebin Shi Chengnan

单位：河北省唐山市工人医院麻醉一科063000

英文单位：The First Department of Anesthesiology Tangshan Gongren Hospital Hebei Province Tangshan 063000 China

关键词：冠状动脉旁路移植术；盐酸右美托咪定；非体外循环；肾功能

英文关键词：Coronaryarterybypassgrafting;Dexmedetomidinehydrochloride;Off-pump;Renalfunction

• 摘要：

• 目的 观察盐酸右美托咪定对非体外循环冠状动脉旁路移植术患者肾功能的影响。方法 选取2014年6月至2016年6月于河北省唐山市工人医院经冠状动脉造影确诊后择期行非体外循环冠状动脉旁路移植术的患者60例。完全随机分为观察组和对照组，各30例。观察组患者术中予盐酸右美托咪定1 μg/（kg·h）缓慢泵注，直至手术结束；对照组患者以相同速度给予同等容量0.9%氯化钠注射液直至手术结束。比较2组患者入室时、术毕时、术后24 h血尿素氮、血肌酐、胱抑素C水平以及术毕时和术后24 h尿量。结果 2组患者术后24 h血尿素氮、血肌酐、胱抑素C水平较入室时均有明显升高，但观察组低于对照组［（7.9±1.6）mmol/L比（9.3±2.3）mmol/L、（76±14）μmol/L比（92±21）μmol/L、（1.01±0.32）mg/L比（1.29±0.31）mg/L］，差异均有统计学意义（均P<0.05）。观察组患者术毕时、术后24 h尿量多于对照组［（2.8±1.3）L比（2.1±1.4）L、（4.5±1.8）L比（2.7±1.9）L］，差异均有统计学意义（均P<0.05）。结论 盐酸右美托咪定具有良好的安全性，对保护非体外循环冠状动脉旁路移植术患者肾功能具有重要意义。

• Objective To observe the effect of dexmedetomidine hydrochloride on renal function in patients undergoing off-pump coronary artery bypass grafting. Methods From June 2014 to June 2016, 60 patients undergoing elevtive off-pump coronary artery bypass grafting after confirmed by coronary angiography in Tangshan Gongren Hospital, Hebei Province were selected. They were randomly divided into observation group and control group, with 30 cases in each group. The patients in the observation group were slowly pumped with dexmedetomidine hydrochloride 1 μg/（kg·h） until the end of srugery; the patients in the control group were slowly pumped with same capacity 0.9% sodium chloride injection at the same speed until the end of srugery. The levels of blood urea nitrogen, serum creatinine and cystatin C at the end of surgery and 24 h after surgery, and the urine volume at the end of surgery and 24 h after surgery were compared between the two groups. Results The levels of blood urea nitrogen, serum creatinine and cystatin C at 24 h after surgery in the two groups were significantly higher than those at the time of entering the operation room, but those in the observation group were lower than those in the control group［(7.9±1.6)mmol/L vs (9.3±2.3)mmol/L, (76±14)μmol/L vs (92±21)μmol/L, (1.01±0.32)mg/L vs (1.29±0.31)mg/L］(all P<0.05). The urine volumes at the end of surgery and 24 h after surgery in the observation group were more than those in the control group［(2.8±1.3)L vs (2.1±1.4)L, (4.5±1.8)L vs (2.7±1.9)L］, and the differences were statistically significant(both P<0.05). Conclusion Dexmedetomidine hydrochloride has good safety and great significance for protecting renal function in patients undergoing off-pump coronary artery bypass grafting.