异丙酚麻醉对脑外伤血肿清除术患者的脑保护作用

发布时间：2018-05-31 15:36

本文选题：异丙酚 + 依托咪酯　；参考：《武警医学》2016年08期

【摘要】：目的观察异丙酚麻醉对脑外伤血肿清除术患者的脑保护作用。方法脑外伤血肿清除术患者60例,随机均分为异丙酚组和依托咪酯组。分别于麻醉前(t0)、插管后(t1)、手术开始后1 h(t2)、手术开始后2 h(t3)记录颈内静脉球氧饱和度(Sjv O2)并计算脑氧摄取率(CERO2)。分别于不同时间点:手术前(T0)、手术开始后1 h(T1)、术后1 h(T2)、术后24 h(T3)抽取颈内静脉血样,检测S100β蛋白含量。术后30 d记录患者的格拉斯哥预后评分(glasgow outcome scale,GOS)和简易智力状况检查评分(mini-mental state examination,MMSE)。结果与t0时比较,t1、t2、t3时两组Sjv O2明显升高(P0.05);异丙酚组t1、t2、t3时CERO2(30.9%±5.04%、30.2%±6.17%、28.7%±3.21%)降低,依托咪酯组的CERO2在t1时(24.9%±4.31%)降低(P0.05);与依托咪酯组比较,异丙酚组t1、t2、t3时Sjv O2明显升高,CERO2降低(P0.05)。患者S100β蛋白含量在T2时异丙酚组为(1.17±0.26)μg/L,小于依托咪酯组的(1.52±0.19)μg/L(P0.05)。两组GOS和MMSE评分没有统计学差异。结论异丙酚在脑外伤血肿清除手术患者具有一定的脑保护作用。
[Abstract]:Objective to observe the protective effect of propofol anesthesia on brain injury patients undergoing hematoma clearance. Methods 60 patients with traumatic hematoma were randomly divided into propofol group and etomidate group. The oxygen saturation of jugular bulb (SjvO2) was recorded before anesthesia, 1 hour after intubation, 1 hour after operation and 2 h after operation. Blood samples of internal jugular vein were collected at different time points: before operation, 1 hour after operation, 24 hours after operation. Glasgow outcome scale (Glasgow) and mini-mental state examination (MMSE) were recorded 30 days after operation. Results compared with T0, the Sjv O 2 of the two groups was significantly higher than that of the control group (P 0.05), the CERO2O 2 of the propofol group was 30.9% 卤5.04% 卤5.04% 卤3.21 at t 1, the CERO2 of the etomidate group was 24.9% 卤4.31% at t 1 and the Sjv O 2 at t 1 t 2t 3 in the propofol group was significantly higher than that in the etomidate group, and Sjv O 2 in the propofol group was significantly higher than that in the etomidate group, and the Sjv O 2 level in the propofol group was significantly higher than that in the etomidate group at t 1 and T 2t 3, and the level of Sjv O 2 in the etomidate group was significantly higher than that in the etomidate group. The S100 尾 protein content in the propofol group was 1.17 卤0.26 渭 g / L at T2, which was lower than that in the etomidate group (1.52 卤0.19) 渭 g / L P / L 0.05. There was no significant difference in GOS and MMSE scores between the two groups. Conclusion propofol has a protective effect on brain injury in patients with hematoma clearance.
【作者单位】：武警北京总队医院麻醉科;
【分类号】：R614

【相似文献】