急性高容量血液稀释对脑动脉瘤夹闭患者认知功能、血清S-100β和氧代谢的影响

发布时间：2018-06-09 11:26

本文选题：急性高容量血液稀释 + 脑动脉瘤　；参考：《中国现代医学杂志》2017年08期

【摘要】：目的探讨急性高容量血液稀释(AHH)对脑动脉瘤夹闭患者认知功能、血清S-100β和氧代谢的影响。方法选取行脑动脉瘤夹闭术的60例患者,随机分为AHH组与对照组,每组30例,均在气管插管全麻下进行手术,AHH组同时实施AHH,观察患者麻醉诱导后即刻(T0)、血液稀释15 min(T_1)、血液稀释60 min(T_2)、手术结束时(T_3)、术后3 d(T_4)时颈静脉血氧饱和度(SjvO_2)、脑动静脉血氧含量差(AVDO_2)、血清S-100β,术前、术后7 d时患者认知功能(MMSE、LOTCA)变化。结果两组术中液体输入量、出血量、尿量、手术时间比较差异无统计学意义(P0.05);SjvO_2、AVDO_2、S100β在不同时点比较差异有统计学意义(P0.05),AHH组与对照组不同时点比较差异有统计学意义(P0.05);MMSE、LOTCA在不同时点比较差异无统计学意义(P0.05),AHH组与对照组不同时点比较差异无统计学意义(P0.05)。结论 AHH对脑动脉瘤夹闭患者早期脑氧代谢有影响,可引起短暂脑损伤,但对患者认知功能无明显影响。
[Abstract]:Objective to investigate the effects of acute hypervolemic hemodilution (AHH) on cognitive function, serum S-100 尾 and oxygen metabolism in patients with cerebral aneurysm clipping. Methods 60 cases of cerebral aneurysm clipping were randomly divided into AHH group and control group, 30 cases in each group. All patients were treated with AHH under tracheal intubation under general anesthesia. The patients were treated with T0 immediately after induction of anesthesia, hemodilution was done 15 min after induction of anesthesia, hemodilution was done in 15 mins, blood diluted in 60 mins, blood diluted at 60 mins, T 2 was diluted. At the end of operation, T3 was taken, and 3 days after operation, SjvO2, jugular venous oxygen saturation (SjvO2), cerebral arteriovenous oxygen saturation (SjvO2), cerebral arteriovenous oxygenation (CVO) were observed. Serum S-100 尾, AVDO2D, before operation, At 7 days after operation, the patients' cognitive function and MMSE LOTCA were changed. Results the volume of fluid input, blood loss, urine volume in the two groups during operation, There was no significant difference in operation time. There was no statistical difference between P0.05 and SjvOster2AVDOD S100 尾 at different time points. There was no significant difference between P0.05 AHH group and control group at different time points. There was no significant difference between P0.05 MMSE LOTCA and AHH group at different time points. There was no significant difference between the two groups at different time points (P 0.05). Conclusion AHH has an effect on cerebral oxygen metabolism in early cerebral aneurysm clipping patients, which can cause transient brain injury, but has no significant effect on cognitive function.
【作者单位】：贵州省遵义市第一人民医院神经外科;
【基金】：贵州省卫生厅科学技术课题(No:Gzwkj2013-1-059)
【分类号】：R651.12

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