摘要
目的探讨异氟烷麻醉对颅脑外伤手术患者血糖、血脂和肾功能的影响。方法选择2011年6月至2013年6月四川省肿瘤医院收治的颅脑外伤手术患者60例,根据麻醉方法不同分为异氟烷组及丙泊酚/芬太尼组,各30例,比较两组患者手术前后血糖及肾功能情况。结果异氟烷组术中3 h出现血糖高峰而后下降,丙泊酚/芬太尼组术后2 h出现血糖高峰,两组不同时点间比较差异有统计学意义(P<0.05);异氟烷组手术前后三酰甘油水平较平稳,丙泊酚/芬太尼组术中1 h、3 h三酰甘油水平显著升高,不同时点间比较差异有统计学意义(P<0.05),且异氟烷组三酰甘油水平低于丙泊酚/芬太尼组(P<0.05)。两组患者术后第1日和第3日的尿量、血肌酐增加,术后第7日下降,不同时点间比较差异有统计学意义(P<0.05),且异氟烷组患者血肌酐升高水平小于丙泊酚/芬太尼组,差异有统计学意义(P<0.05)。结论颅脑外伤手术患者采用异氟烷麻醉时对三酰甘油的改变不大,术中患者血糖可大幅升高,当患者合并糖尿病等基础疾病时需予以注意,异氟烷麻醉对患者肾功能的保护作用主要体现在对肌酐的较好控制,而对尿素氮及尿酸影响不大。
Objective To investigate the effects of isoflurane anesthesia on blood glucose and renal function of brain trauma patients. Methods A total of 60 cases of traumatic brain injury undergoing surgery anesthesia admitted to Sichuan Provincial Tumor Hospital from Jun. 2011 to Jun. 2013 were included in the study. According to their different use of narcotic drugs,the patients were divided into the isoflurane group and propofol / fentanyl group,30 cases in each group. Blood glucose and renal function in patients before and after surgery were analyzed. Results The blood glucose peak appeared at 3rd hour during operation and then decline in the isoflurane group,while in the propofol / fentanyl group the blood glucose peak appeared at 2nd hour after operation,the difference at different time points between the two groups was statistically significant（ P 0. 05）; triglyceride（ TG） levels before and after operation of isoflurane group was relatively stable,of propofol / fentanyl group was significantly increased at 1 h,3 h,there were statistically significant differences among the different time points（ P 0. 05）,and TG level of the isoflurane group was lower than the propofol / fentanyl group（ P 0. 05）. The urine volume and serum creatinine of both groups at the first and third day after operation were increased,at the seventh day were declined,there were statistically significant differences among the different time points（ P 0. 05）,and serum creatinine level increase of isoflurane group was less than propofol / fentanyl group,the difference was statistically significant（ P 0. 05）. Conclusion Isoflurane anesthesia has little effect on TG,but blood glucose is increased significantly during surgery,which calls for attention to patients complicated with primary diseases such as diabetes. Isoflurane anesthesia＇s protective role on renal function is mainly reflected in better control of creatinine,while it has little influence on Bun and uric acid.
出处
《医学综述》
2015年第2期383-384,F0003,共3页
Medical Recapitulate
关键词
异氟烷
颅脑手术
血糖
肾功能
Isoflurane
Craniocerebral surgery
Blood glucose
Renal function
