摘要
目的：探讨丙泊酚联合芬太尼在重型颅脑损伤并脑疝形成患者急症手术的麻醉效果，旨在提高麻醉效果，为临床实践提供依据。方法：对我院2005年1月-2009年12月60例重型颅脑损伤并脑疝形成急症手术患者，按照麻醉方式的不同分为丙泊酚联合芬太尼（PF）组和异氟醚（Ⅰ）组。观察并比较两组的生命体征和麻醉效果。结果：两组均无麻醉死亡，经扩容、降低颅内压处理，围术期循环稳定，未发生血流动力学剧变等严重并发症，各项生命体征平稳。联合治疗组的恶心呕吐率明显低于对照组，且两组间的差异具有统计学意义（P〈0．05）。联合治疗组的血糖、心率和血压状况也更加稳定。结论：丙泊酚微量泵静注联合芬太尼对重型颅脑损伤并脑疝形成患者行手术者具有良好的麻醉效果，应在临床上推广应用。
Objective To explore the anesthetic effect of propofol combined with fentanyl in acute surgery of severe head injury with hernia formation patients, aimed at improving the anesthetic effect, providing basis for clinical practice. Methods 60 patients with severe head injury and the formation of acute cerebral hernia were carried surgery in our hospital from January 2005 - Dec 2009. All patients were divided into propofol combined with fentanyl （PF） group and isoflurane （I） group according to different anesthesia methods. Observe and compare the vital signs and anesthetic effect of two groups. Results through expansion and reduce intracranial pressure treatment, There were no anesthetic deaths, perioperative cycle maintained a stable hemody- namie serious complications such dramatic changes, and vital signs were stable. The occurrence of nausea and vomiting in treatment group was significantly lower than the control group, and the difference between the two groups was statistically significant （p 〈0.05）. The blood glucose, heart rate and blood pressure were more stable in treatment group. Conclusion There was a good anesthetic effect of propofol combined with fentanyl on the formation of severe head injury and hernia surgery patients. It should be used widely in clinical application.
关键词
丙泊酚
颅脑损伤
手术治疗
麻醉
Propofol
brain injury
surgical treatment
anesthesia
