丙泊酚全麻对无抽搐电休克患者中枢神经的保护机制

发布时间：2018-03-29 06:42

本文选题：丙泊酚　切入点：无抽搐电休克　出处：《广东医学》2017年16期

【摘要】：目的比较丙泊酚与依托咪酯静脉麻醉对无抽搐电休克患者治疗前后血清S100B蛋白、NSE含量变化及患者认知功能影响,探讨丙泊酚麻醉对电休克患者中枢神经的保护机制。方法选取首次入院诊断为精神分裂症患者30例,随机分为丙泊酚组(P组)与依托咪酯组(E组)。P组采用丙泊酚2 mg/kg静脉注射全身麻醉,E组采用依托咪酯0.6 mg/kg静脉注射全身麻醉。分别在MECT术前、第1次和第6次MECT后检测血清S100B蛋白和NSE;采用简易智能状态检查量表(MMSE)行认知功能测评。结果电疗前两组患者血清S100B蛋白、NSE和MMSE测评差异无统计学意义(P0.05);在第1、6次电疗后S100B蛋白和NSE均比电疗前水平增加,但P组低于E组,差异有统计学意义(P0.05);第1、6次电疗后24 h内MMSE评分均比电疗前降低,但P组高于E组,差异有统计学意义(P0.05)。结论丙泊酚或依托咪酯静脉全麻行MECT治疗均可引起术后早期认知功能损害,但丙泊酚静脉全麻对认知功能影响较少,其可能与NSE和S100B蛋白表达增加幅度较低有关。
[Abstract]:Objective to compare the effects of intravenous anesthesia with propofol and etomidate on the changes of serum S100B protein NSE and cognitive function in patients without convulsive electroshock before and after treatment. To explore the protective mechanism of propofol anesthesia on central nervous system in electroshock patients. They were randomly divided into propofol group (P group) and etomidate group (group E) and etomidate group (group E) were treated with propofol 2 mg/kg intravenous general anesthesia and group E with etomidate 0.6 mg/kg intravenous general anesthesia, respectively before MECT. After the first and sixth MECT, the serum S100B protein and NSE were measured, and the cognitive function was evaluated with the simple Mental State examination scale. Results there was no significant difference in the serum S100B protein and MMSE between the two groups before electrotherapy (P 0.05), and in the first stage of the study, the cognitive function of the two groups was not significantly higher than that of the control group (P < 0.05), and no significant difference was found between the two groups before electrotherapy (P < 0.05). The levels of S100B protein and NSE increased after secondary electrotherapy. But P group was lower than E group (P 0.05), the MMSE score of P group was lower than that of E group within 24 h after the first 6 times of electrotherapy, but P group was higher than E group. Conclusion propofol or etomidate intravenous general anesthesia can cause early cognitive impairment after operation, but propofol intravenous general anesthesia has little effect on cognitive function. It may be related to the low increase of NSE and S100B protein expression.
【作者单位】：广州市惠爱医院麻醉科;南方医科大学珠江医院麻醉科;
【基金】：广州市医药卫生科技项目(编号:20151A010065)
【分类号】：R749.05

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