摘要
目的观察丁苯酞与醒脑静联用预防颈动脉内膜剥脱术后脑高灌注综合征的临床疗效及对脑氧代谢及氧化应激的影响。方法选取2019年1月—2021年6月期间河南省南阳市中心医院择期行颈动脉内膜剥脱术患者68例,按随机数字表法分为对照组和观察组,每组各34例。所有患者均行围术期常规处理,对照组手术前应用丁苯酞治疗,观察组在对照组基础上加用醒脑静注射液治疗,均在术后7 d停药。观察比较两组患者脑高灌注综合征的发生率,脑血流指标[大脑中动脉舒张期末流速(End diastolic velocity,EDV)、收缩期峰值流速(Peak systolic velocity,PSV)、平均流速(Average velocity,MV)],脑氧代谢指标[静脉氧饱和度(Oxygen saturation in venous blood,SjvO_(2))、颈动静脉氧含量差值(Cerebral arterio-jugular venous oxygen content difference,Ca-jvO_(2))]、氧化应激指标[丙二醛(Malondialdehyde,MDA)、氧化物歧化酶(Superoxide dismutase,SOD)]水平。结果术后7 d内观察组脑高灌注综合征发生率2.94%(1/34)低于对照组发生率17.65%(6/34),差异有统计学意义(P<0.05)。两组患者T1和T2时EDV、PSV及MV均较T0升高,差异有统计学意义(P<0.05);且观察组T1、T2及T3时EDV、PSV及MV明显低于对照组,差异有统计学意义(P<0.05)。两组患者T1和T2时SjvO_(2)均较T0降低,Ca-jvO_(2)升高,差异有统计学意义(P<0.05);且观察组T1、T2及T3时SjvO_(2)明显高于对照组,Ca-jvO_(2)明显低于对照组,差异有统计学意义(P<0.05)。两组患者T1和T2时SOD均较T0降低,MDA升高,差异有统计学意义(P<0.05);且观察组T1、T2及T3时SOD明显高于对照组,MDA明显低于对照组,差异有统计学意义(P<0.05)。结论丁苯酞胶囊与醒脑静注射液联用能减少颈动脉内膜剥脱术后脑高灌注综合征的发生率,调节患者的脑血流量,纠正脑氧代谢失衡,改善氧化应激。
Objective To observe the performance of butylphthalide combined with Xingnaojing in preventing cerebral hyperperfusion syndrome after carotid endarterectomy and the effect of this therapy on cerebral oxygen metabolism and oxidative stress.Methods A total of 68 patients undergoing carotid endarterectomy in Nanyang Central Hospital from January 2019 to June 2021 were randomized into a control group(n=34)and an observation group(n=34)according to the random number table method.All the patients received routine treatment during the perioperative period.The control group was treated with butylphthalide before operation,and the observation group with Xingnaojing injection combined with butylphthalide.The drugs were withdrawn 7 days after operation.The incidence of cerebral hyperperfusion syndrome was compared between the two groups.The carotid blood flow indexes[end diastolic velocity(EDV),peak systolic velocity(PSV),and mean velocity(MV)],cerebral oxygen metabolism indexes[oxygen saturation in venous blood SjvO_(2) and cerebral arterio-jugular venous oxygen content difference(Ca-jvO_(2))],and oxidative stress indexes[malondialdehyde(MDA)and superoxide dismutase(SOD)]were determined.Results The incidence of cerebral hyperperfusion syndrome within 7 days after operation in the observation group was 2.94%(1/34),which was lower than that(17.65%,6/34)in the control group(P<0.05).The EDV,PSV,and MV in both groups were higher at T1 and T2 than at T0,and the observation group had lower EDV,PSV,and MV than the control group at T1,T2,and T3(P<0.05).The SjvO_(2) of both groups was lower at T1 and T2 than at T0,and Ca-jvO_(2) showed the opposite trend.Moreover,the observation group had higher SjvO_(2) and lower Ca-jvO_(2) than the control group at T1,T2,and T3(P<0.05).The SOD of both groups was lower at T1 and T2 than at T0,and the MDA showed the opposite trend.Moreover,the observation group had higher SOD and lower MDA than the control group(P<0.05).Conclusion The combination of butylphthalide capsules and Xingnaojing injection can reduce the incidence of cerebral hyperperfusion syndrome after carotid endarterectomy by regulating the cerebral blood flow,correcting the cerebral oxygen metabolism disorder,and alleviating oxidative stress.
作者
陈欢
司海超
马新强
刘远征
柳雨
司小萌
CHEN Huan;SI Hai-chao;MA Xin-qiang;LIU Yuan-zheng;LIU Yu;SI Xiao-meng(First Department of Surgery,Nanyang Central Hospital,Nanyang Henan 473000;The Second Ward of Neurosurgery,Nanyang Central Hospital,Nanyang Henan 473000;Second Department of Surgery,Nanyang Central Hospital,Nanyang Henan 473000)
出处
《世界中西医结合杂志》
2023年第7期1462-1465,1475,共5页
World Journal of Integrated Traditional and Western Medicine
基金
2019年河南省科技公关计划(联合共建)项目(LHGJ20191455)。
关键词
丁苯酞
醒脑静
颈动脉内膜剥脱术
脑高灌注综合征
脑氧代谢
氧化应激
Butylphthalide
Xingnaojing
Carotid Endarterectomy
Cerebral Hyperperfusion Syndrome
Brain Oxygen Metabolism
Oxidative Stress
