摘要
目的:探讨丙泊酚静脉麻醉对颅脑外伤手术患者神经功能的影响。方法:选取2015年2月至2018年2月武警浙江省总队嘉兴医院收治的拟行颅脑外伤手术患者70例,采用随机数字表法分为静脉麻醉组(丙泊酚麻醉)和吸入麻醉组(七氟醚麻醉),每组35例。于T_0(麻醉诱导前)、T_1(麻醉诱导后1 min)、T_2(手术30 min)及T_3(术毕)观察两组患者的颈总动脉平均血流速度(Vm)、脉搏指数(PI)、颈静脉球血氧饱和度(SjvO_2)及动脉-颈内静脉血氧含量差(Da-jvO_2),于术前、术后2 h观察两组患者的血清S100B蛋白、神经元特异性烯醇化酶(NSE)、一氧化氮(NO)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平。结果:T_1、T_2及T_3时,静脉麻醉组患者Vm、Da-jvO_2明显低于吸入麻醉组,PI、SjvO_2明显高于吸入麻醉组,差异均有统计学意义(P<0.05)。术前,两组患者血清S100B蛋白、NSE水平的差异无统计学意义(P>0.05);术后2 h,静脉麻醉组患者血清S100B蛋白、NSE水平明显低于吸入麻醉组,差异均有统计学意义(P<0.05)。术前,两组患者血清NO、MDA及SOD水平的差异无统计学意义(P>0.05);术后2 h,静脉麻醉组患者血清NO、MDA水平明显低于吸入麻醉组,SOD水平明显高于吸入麻醉组,差异均有统计学意义(P<0.05)。结论:丙泊酚静脉麻醉可降低颅脑外伤手术患者的Vm,减少脑组织耗氧量,降低血清S100B蛋白、NSE水平和氧化应激水平,从而达到保护脑功能的目的。
OBJECTIVE： To probe into the effects of propofol for intravenous anesthesia on neurological function in patients with craniocerebral trauma. METHODS： 70 patients with craniocerebral trauma undergoing surgeries admitted into Jiaxing Hospital of Armed Police Zhejiang Provincial Team from Feb. 2015 to Feb. 2018 were selected and divided into intravenous anesthesia group（propofol fpr anesthesia） and inhalation anesthesia group（sevoflurane for anesthesia） via random number tables, with 35 cases in each group. The mean total blood flow velocity（Vm）, pulse index（PI）, jugular bulb oxygen saturation（SjvO_2） and arterial-intracervical venous blood oxygen content（Da-jvO_2） of two groups were observed in T_0（before the induction of anesthesia）, T_1（1 min after the induction of anesthesia）, T_2（30 min after operation） and T_3（after operation）. The levels of serum S100 B protein, neuron-specific enolization, nitric oxide（NO）, malondialdehyde（MDA） and superoxide dismutase（SOD） of two groups were observed at before and 2 h after operation. RESULTS： At T_1, T_2 and T_3, the Vm and Da-jvO_2 of intravenous anesthesia group were significantly lower than those of the inhalation anesthesia group, the PI and SjvO_（2 ）of intravenous anesthesia group were significantly higher than the inhalation anesthesia group, with statistically significant differences（P0.05）; before operation, there were no statistical significance in differences in serum S100 B protein and NSE levels between two groups（P0.05）; at 2 h after operation, levels of serum S100 B protein and NSE of intravenous anesthesia group were significantly lower than those of the inhalation anesthesia group, with statistically significant differences（P0.05）. Before operation, there were no statistically significance in differences in serum NO, MDA and SOD levels between two groups（P0.05）; at 2 h after operation, the serum NO and MDA levels of intravenous anesthesia group were significantly lower than those of the inhalation anesthesia group, and the SOD level was significantly higher, with statistically significant differences（P0.05）. CONCLUSIONS： Propofol for intravenous anesthesia can lower the Vm of patients with craniocerebral trauma, reduce the oxygen consumption of brain tissue, reduce the serum S100 B protein, NSE and oxidative stress levels, so as to achieve the purpose of protecting brain function.
作者
严厚福
杨世忠
朱德琴
YAN Houfu;YANG Shizhong;ZHU Deqin(Dept.of Anesthesiology,Jiaxing Hospital of Ataned Police Zhejiang Provincial Team,Zhejiang Jiaxing 214000,China;Dept.of Gynecology,Jiaxing Hospital of Ataned Police Zhejiang Provincial Team,Zhejiang Jiaxing 214000,China)
出处
《中国医院用药评价与分析》
2018年第10期1340-1342,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
颅脑外伤
丙泊酚
静脉麻醉
神经功能
Brain trauma
Propofol
Intravenous anesthesia
Neurological function
