丙泊酚对op-CABG患者认知功能及神经生长因子的影响

发布时间：2018-05-05 12:54

本文选题：丙泊酚 + 麻醉　；参考：《中国现代医学杂志》2017年26期

【摘要】：目的探讨不同丙泊酚靶控麻醉维持剂量对非体外循环下冠状动脉旁路移植术(op-CABG)患者术后认知功能障碍(POCD)及神经生长因子(NGF)表达水平的影响。方法选取2013年5月-2015年4月在该院实施co-CABG术的105例患者,按照数字表法分成3组,根据丙泊酚靶控麻醉剂量的不同分为高剂量组(丙泊酚3.0μg/ml)、中剂量组(丙泊酚2.5~3.0μg/ml)、低剂量组(丙泊酚2.5μg/ml),每组35例,比较3组患者在手术时间、麻醉时间、POCD发生率的差异,并对麻醉各时期3组麻醉深度、血流动力学指标及NGF表达水平进行比较。结果 3组患者在手术时间、麻醉时间比较,差异无统计学意义(P0.05),但中、高剂量组POCD发生率分别为11.4%和5.7%,均低于低剂量组的31.4%(P0.05);中、高剂量组麻醉深度、平均动脉压比较差异无统计学意义(P0.05),但两者数值低于低剂量组(P0.05);而3组围手术期中心率变化比较,差异无统计学意义(P0.05);手术结束后,中、高剂量组患者NGF表达水平也高于低剂量组(P0.05)。结论 2.5~3.0μg/ml丙泊酚靶控剂量维持麻醉可在获得满意麻醉深度的同时,减少药物对机体血流动力学的影响,并有利于降低POCD的发生,促进NGF的表达。
[Abstract]:Objective to investigate the effects of different maintenance doses of propofol target-controlled anesthesia on the expression of POCDand NGF in patients with cognitive dysfunction and NGF after off-pump coronary artery bypass grafting (CABG). Methods 105 patients undergoing co-CABG from May 2013 to April 2015 were divided into 3 groups according to digital table method. According to the different dose of propofol target controlled anesthesia, the patients were divided into high dose group (propofol 3.0 渭 g / ml), middle dose group (2.5 渭 g / ml propofol 2.5 渭 g / ml) and low dose group (2.5 渭 g / ml propofol, 35 cases in each group). The anesthetic depth, hemodynamic index and NGF expression were compared among the three groups. Results there was no significant difference in the operation time and anesthesia time among the three groups, but the incidence of POCD in the middle and high dose groups was 11.4% and 5.7, respectively, which was lower than that in the low dose group (31.4%, P 0.05), and the anesthetic depth in the middle and high dose group was lower than that in the high dose group. There was no significant difference in mean arterial pressure between the two groups, but the mean arterial pressure was lower than that in the low dose group (P 0.05), but there was no significant difference between the three groups in the central rate during the perioperative period (P 0.05). The expression of NGF in high dose group was higher than that in low dose group (P 0.05). Conclusion maintenance of target controlled dose of 2.5 渭 g/ml propofol can not only obtain satisfactory anesthetic depth, but also reduce the effect of drug on hemodynamics, decrease the occurrence of POCD and promote the expression of NGF.
【作者单位】：河北大学附属医院麻醉科;河北省望都县人民医院麻醉科;河北省定州市人民医院麻醉科;
【分类号】：R614

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