| 马 磊,陈希瑶,赵 静,贾 济,吴明春,朱萧玲.丙泊酚镇静对颅脑损伤患者脑氧供需平衡的影响[J].,2018,(16):306-3079 |
| 丙泊酚镇静对颅脑损伤患者脑氧供需平衡的影响 |
| Effects of Propofol on the Brain Oxygen Balance in Traumatic Brain Injury Patients |
| 投稿时间：2018-03-01 修订日期：2018-03-24 |
| DOI：10.13241/j.cnki.pmb.2018.16.016 |
| 中文关键词: 颅脑损伤 脑电双频谱指数 丙泊酚 靶控输注 |
| 英文关键词: Traumatic brain injury Bispectral index Propofol Target controlled infusion |
| 基金项目:国家自然科学基金项目（81601148） |
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| 中文摘要: |
| 摘要 目的：探讨丙泊酚实施不同程度镇静对颅脑损伤患者脑氧供需平衡的影响。方法：选择急性闭合性颅脑损伤需行机械通气患者46例，随机分为轻度镇静组(A组)，设定目标脑电双频谱指数(BIS)值75 %；中度镇静组(B组)，设定目标BIS值65 %。主要观察达设定目标BIS值时丙泊酚靶控输注(TCI)浓度、Ramsay镇静评分、脑氧供需平衡指标颈内静脉血氧饱和度(SjvO2)和脑氧摄取率(CERO2)以及心率(HR)、平均动脉压(MAP)。结果：两组设定镇静目标需丙泊酚TCI浓度有明显差异(P<0.05)，但Ramsay评分比较差异无统计学意义；中度镇静组SjvO2较基础值增加约12 %(P<0.05)，CERO2较基础值下降约15 %(P<0.05)；而轻度镇静组对SjvO2和CERO2基础值没有影响。两组HR均较基础值减慢(P<0.05)，但对MAP均没有影响。结论：颅脑损伤患者维持目标镇静BIS值65 %，调控丙泊酚靶浓度1.5-1.6 μg/mL，更有利于改善脑氧供需平衡。 |
| 英文摘要: |
| ABSTRACT Objective: To determine the impact of propofol on the brain oxygen balance in traumatic brain injury patients. Methods: 46 patients who were diagnosed as acute closed traumatic brain injury and needed mechanical ventilation were divided into two groups: Group A (mild sedation), the target Bispectral Index (BIS) value at about 75; Group B (moderate sedation), the target BIS value at about 65. The propofol target controlled infusion (TCI) concentration, Ramsay score, jugular venous oxygen saturation (SjvO2), cerebral oxygen uptake rate (CERO2), heart rate (HR) and mean arterial blood pressure (MAP) were mainly observed. Results: Propofol TCI concentrations were significantly different between two groups both at T1 (6 hours after onset of sedation) and T2 (12 hours after onset of sedation) time points (P<0.05). In group B, compared with basis value, SjvO2 were significantly increased by 12 % (P<0.05), and CERO2 were significantly reduced by 15 % (P<0.05). While in group A, compared with basis value, SjvO2 and CERO2 had no change. Conclusion: Using 1.5-1.6 μg/mL propofol TCI concentration to maintain target sedation BIS value at 65 is more beneficial to balance brain oxygen supply and demand. |
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