右美托咪定与丙泊酚复合麻醉在减轻脑胶质瘤切除术患者脑损伤中的效果比较

发布时间：2018-04-09 14:34

本文选题：脑胶质瘤　切入点：切除术　出处：《华中科技大学学报(医学版)》2015年06期

【摘要】：目的比较右美托咪定与丙泊酚复合麻醉在减轻脑胶质瘤切除术患者脑损伤中的效果。方法 91例脑胶质瘤患者随机分为右美托咪定组(n=47)和丙泊酚组(n=44),麻醉诱导前,右美托咪定组采用1μg/kg右美托咪定进行静脉输注,丙泊酚组采用等容量的生理盐水进行静脉输注,均输注10min。麻醉诱导后,右美托咪定组采用0.2~0.9μg/(kg·h)右美托咪定静脉输注,丙泊酚组采用3~9mg/(kg·h)丙泊酚静脉输注,用顺阿曲库铵、瑞芬太尼和异氟烷麻醉维持。记录2组患者手术一般情况、苏醒时间和气管插管拔除时间,分别于麻醉诱导前(T_0)、硬脑膜切开时(T_1)、取出瘤体时(T_2)、拔管时(T_3)和术后24h(T_4),采用ELISA法检测血清中PI3K、iNOS、NSE和S100β蛋白水平。结果右美托咪定组患者苏醒时间和气管插管拔除时间均短于丙泊酚组,差异均有统计学意义(均P0.05);与T0时相比,两组患者T2~4时血清PI3K、iNOS、NSE和S100β蛋白含量均出现升高,差异均有统计学意义(均P0.05);右美托咪定组患者T3~4时PI3K、iNOS、NSE和S100β蛋白均低于丙泊酚组,差异均有统计学意义(均P0.05)。结论右美托咪定复合麻醉应用于脑胶质瘤切除术可有效保护脑组织,减少脑组织损伤,其效果优于丙泊酚复合麻醉。
[Abstract]:Objective to compare the effects of dexmetomidine and propofol combined anesthesia on brain injury in patients with glioma resection.Methods 91 patients with glioma were randomly divided into two groups: dexmetomidine group (n = 47) and propofol group (n = 44). Before anesthesia induction, 1 渭 g/kg dexmetomidine was used for intravenous infusion in the right metoimidine group, while the propofol group was given the same volume of normal saline.The average infusion time was 10 minutes.After anesthesia induction, dexmetomidine group was treated with 0.2 卤0.9 渭 g/(kg / h) dexmetomidine, and propofol group with 3~9mg/(kg _ (h) propofol. Anesthesia was maintained with cisatracurium, remifentanil and isoflurane.Results the recovery time and tracheal intubation extubation time of dexmetomidine group were shorter than that of propofol group (all P 0.05), compared with T0, the levels of serum PI3KNSE and S100 尾 protein in T2 ~ 4 group were higher than those in T0 group.The difference was statistically significant (all P 0.05, P 0.05), and the protein levels of PI3KNSE and S100 尾 in the dexmetomidine group were significantly lower than those in the propofol group at T 3 ~ 4 (all P 0.05).Conclusion dexmetomidine combined anesthesia can effectively protect brain tissue and reduce brain tissue injury after glioma resection, and the effect is better than that of propofol combined anesthesia.
【作者单位】：河南省新乡市中心医院麻醉科;河南省焦作市焦煤中央医院麻醉科;
【分类号】：R614;R739.4

【相似文献】