摘要
目的：探讨力月西联合丙泊酚静脉麻醉对中重度颅脑损伤手术患者的影响。方法：选取笔者所在医院收治的86例颅脑损伤后行手术治疗的患者，随机分为观察组和对照组，各43例。观察组给予力月西0.04~0.06 mg/kg、丙泊酚1.5~2.0 g/kg、芬太尼4μg/kg、维库溴胺0.1 mg/kg诱导麻醉；对照组给予1.2％异氟醚吸入诱导麻醉。两组患者均采用维库溴铵0.02~0.03 mg/（kg·h）、芬太尼2~4μg/（kg·h）维持麻醉，比较两组患者术中颅内压（ICP），脑氧分压（PbrO2），平均动脉压（MAP）、心率（HR）、血氧分压（SpO2）指标，并应用视觉模糊疼痛评分（VAS）和躁动评分（GCS）评估术后镇静镇痛效果。结果：观察组和对照组患者不同时点血液动力学相关指标MAP、HR、SpO2比较差异无统计学意义（P〉0.05），ICP、PbrO2水平间比较差异有统计学意义（F=4.321，P=0.027；F=3.998，P=0.034）；两组间比较输注后2 h（T4）和术毕（T5）观察组患者ICP较对照组低（t=2.37，P=0.019；t=4.75，P〈0.001），而PbrO2值较对照组高（t=2.68，P=0.009；t=4.06，P〈0.001）；术后第2天、第3天观察组VAS评分低于对照组（t=2.49，P=0.015；t=5.78，P〈0.001），GCS评分低于对照组（t=4.28，P〈0.001；t=8.15，P〈0.001）。结论：力月西联合丙泊酚静脉麻醉术中循环稳定，术后镇静镇痛效果好，并对脑组织有一定保护作用，在颅脑损伤手术患者中应用效果良好。
Objective：To investigate the anesthesia effect of propofol with midazolam in emergency operation for patients with traumatic brain injury. Method：Selected the author’s hospital treated 86 cases of patients with craniocerebral trauma after surgery,were randomly divided into observation group and control group,43 cases each. Observation group was given force on west 0.04-0.06 mg/kg,propofol 1.5-2.0 g/kg,fentanyl 4μg/kg,vecuronium bromide amine 0.1 mg/kg induction of anesthesia;the control group given 1.2%isoflurane inhalation induction of anesthesia.Maintain anesthesia of vecuronium 0.02-0.03 mg/（kg·h）,fentanyl 2-4μg/（kg·h） were all gave to patients in two group,the intracranial pressure（ICP）,brain oxygen tension （PbrO2）,mean arterial pressure（MAP）,heart rate（HR）, blood oxygen（SpO2） were compared,and postoperative sedation and analgesia effect were assessed by vision pain score（VAS） and agitation score （GCS）.Result：MAP, HR,SpO2 between two group showed no statistically significant difference（P＆gt;0.05）,levels of ICP（F=4.321,P=0.027） ,PbrO2（F=3.998,P=0.034） had statistical difference;compared in different time,ICP in T4,T5 in observation group were lower than control group （t=2.37,P=0.019;t=4.75,P〈0.001）,PbrO2 values were higher than control group （t=2.68,P=0.009;t=4.06,P〈0.001）;first two days after the first three days VAS scores （t=2.49,P=0.015;t=5.78,P〈0.001）, GCS score in the observation group were lower than control group at 2,3 day after surgery（t=4.28,P〈0.001;t=8.15,P〈0.001）. Conclusion：Intravenous anesthesia with propofol and midazolam should bring the outcome of circulation stability,and have the good effect of postoperative sedation and analgesia,it also has the protective effect in brain tissue.
出处
《中外医学研究》
2014年第11期7-9,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
力月西
丙泊酚
颅脑损伤
脑保护
麻醉
Midazolam
Propofol
Traumatic brain injury
Cerebral protection
Anesthesia
