右美托咪定复合芬太尼及七氟烷对幕上脑肿瘤患者血清NSE、S-100β、SOD和MDA含量及脑氧供需平衡的影响

发布时间：2018-02-26 22:42

本文关键词： 右美托咪定幕上脑肿瘤脑氧供需平衡神经原特异性烯醇化酶 S-β蛋白超氧化物歧化酶丙二醛　出处：《华中科技大学学报(医学版)》2017年01期 　论文类型：期刊论文

【摘要】：目的观察右美托咪定复合芬太尼及七氟烷对幕上脑肿瘤患者血清神经原特异性烯醇化酶(NSE)、S-100β蛋白,超氧化物歧化酶(SOD),以及丙二醛(MDA)含量及脑氧供需平衡的影响。方法选择幕上脑肿瘤患者70例,随机分为实验组和对照组,实验组在麻醉诱导前给予右美托咪定,对照组给予等量生理盐水,其他处理相同。于全麻诱导前(T1)、气管插管(T2)、切开硬脑膜(T3)、切开硬脑膜1 h后(T4)、硬脑膜缝合时(T5)、术后24 h(T6)6个时间点检测动-静脉血氧含量差(Ca-jvO_2)、颈内静脉球部血氧饱和度(SjvO_2),脑氧摄取率(CERO_2),血清NSE、S-100β、SOD和MDA含量。结果针对Ca-jvO_2及CERO_2指标,实验组在T3、T4、T5及T6时点相比对照组均降低(均P0.05)。针对SjvO_2指标,实验组在T3、T4、T5及T6时点相比对照组均升高(均P0.05)。针对SOD含量,实验组在各时间点相比对照组均升高(均P0.05)。针对MDA含量,实验组在T3、T4、T5及T6时点相比对照组均降低(均P0.05)。针对S-100β含量,实验组在T2、T3、T4、T5及T6时点相比对照组均降低(均P0.05)。针对NSE含量,实验组在T3、T4、T5及T6时点相比对照组均降低(均P0.05)。结论右美托咪定可显著改善脑氧供需平衡,下调颅内自由基含量,降低多种脑损伤的特异性蛋白含量,从而实现脑保护作用。
[Abstract]:Objective to observe the effect of dexmetomidine combined with fentanyl and sevoflurane on serum neurogen-specific enolase (NSEE) S-100 尾 protein in patients with supratentorial brain tumors. The effects of superoxide dismutase (SOD) and malondialdehyde (MDA) on the balance of cerebral oxygen supply and demand. Methods 70 patients with supratentorial brain tumor were randomly divided into experimental group and control group. The experimental group was given dexmetomidine before anesthesia induction. The control group was given the same amount of normal saline. The other treatments were the same. Before the induction of general anesthesia, T1, endotracheal intubation, T2J, T3 incision of dura mater, 1 hour after dural incision, T5 and T5 during dura mater suture, and 24 h after operation, the difference in oxygen content in arteriovenous blood was detected at 6 time points: Ca-jvO2, blood oxygen saturation in jugular venous bulbar of jugular vein. SjvO2s, cerebral oxygen uptake rate, serum NSES-100 尾 -SOD and MDA contents. The experimental group was lower than the control group at the time of T3, T4, T5 and T6 (all P 0.05). For the SjvO_2 index, the experimental group was higher than the control group at T3, T4, T5 and T6. For the SOD content, the experimental group was higher than the control group at each time point (all P0.05.The content of MDA was higher than that of the control group. The levels of S-100 尾 in the experimental group were significantly lower than those in the control group at the time points of T3, T4, T5 and T6 (all P 0.05). For the S-100 尾 content, the levels of S-100 尾 in the experimental group were lower than those in the control group at the time points of T2, T3, T4, T5 and T6 (all P 0.05). Conclusion dexmetomidine can significantly improve the balance of cerebral oxygen supply and demand, down-regulate the content of intracranial free radicals and decrease the specific protein content of various kinds of brain injury, so as to realize the protective effect of dexmetomidine on brain injury in the experimental group compared with the control group at the time points of T3, T4, T5 and T6.
【作者单位】：河南科技大学第一附属医院新区医院麻醉科;河南科技大学第一附属医院新区医院神经外科;
【分类号】：R614;R739.41

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