| 王仕斌,王雪婷,薛荣亮,陈 蓉,路丕周,刘世明.异丙酚联合地氟烷麻醉对颅脑损伤患者脑保护及脑供氧平衡的影响[J].,2019,19(24):4793-4796 |
| 异丙酚联合地氟烷麻醉对颅脑损伤患者脑保护及脑供氧平衡的影响 |
| Effects of Propofol Combined with Desflurane Anesthesia on Brain Protection and Brain Oxygen Supply Balance in Patients with Craniocerebral Injury |
| 投稿时间：2019-08-23 修订日期：2019-09-18 |
| DOI：10.13241/j.cnki.pmb.2019.24.045 |
| 中文关键词: 异丙酚 地氟烷 颅脑损伤 脑保护 脑供氧平衡 |
| 英文关键词: Propofol Desflurane Craniocerebral injury Brain protection Brain oxygen supply balance |
| 基金项目:陕西省卫生厅科研基金项目（2015JM6129） |
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| 中文摘要: |
| 摘要 目的：探讨异丙酚联合地氟烷麻醉对颅脑损伤患者脑保护及脑供氧平衡的影响。方法：选取我院2018年1月至2019年1月接受手术治疗的80例颅脑损伤患者，按照双盲随机原则将入选对象分为研究组和对照组各40例，两组患者采取相同的术前麻醉诱导，术中对照组患者采取异丙酚维持麻醉，研究组患者采取异丙酚联合地氟烷维持麻醉，对比两种麻醉方案对颅脑损伤患者脑保护及脑供氧平衡的影响。结果：研究组患者苏醒时间、定力恢复时间明显短于对照组（P＜0.05）；两组患者诱导前脑氧分压（PbrO2）对比差异无统计学意义（P＞0.05），术中及术后，研究组患者PbrO2水平明显高于对照组（P＜0.05）；术毕及术后1 h，研究组患者丙二醛（MDA）、谷氨酸（Glu）均明显低于对照组（P＜0.05），而血浆超氧化物歧化酶（SOD）明显高于对照组（P＜0.05）；T0时刻，两组患者脑氧摄取率（OER）、动-静脉血氧含量差（Da-jvO2）、脑灌注压（CPP）、平均动脉压（MAP）对比无统计学差异（P＞0.05），T1-T3时刻，两组患者OER、Da-jvO2、CPP、MAP对比差异有统计学意义（P＜0.05）。结论：异丙酚联合地氟烷用于颅脑损伤患者的麻醉，具有稳定的麻醉效果，并可保护患者脑组织，维持脑供氧平衡，确保手术顺利开展，且预后效果良好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of propofol combined with desflurane anesthesia on brain protection and brain oxygen supply balance in patients with craniocerebral injury. Methods: 80 patients with craniocerebral injury who were operated in our hospital from January 2018 to January 2019 were selected. According to the double-blind randomized principle, the selected subjects were divided into study group and control group with 40 cases each. The patients in the two groups were given the same preoperative anesthesia induction. During the operation, the patients in the control group were given propofol to maintain anesthesia, while the patients in the study group were given propofol combined with desflurane to maintain anesthesia. Comparison of the effects of two anesthesia schemes on brain protection and brain oxygen supply balance in patients with craniocerebral injury. Conclusion: The recovery time and set force recovery time of patients in the study group was significantly shorter than that in the control group(P＜0.05). There was no significant difference in partial pressure of brain oxygen(PbrO2) before induction between the two groups (P>0.05). During and after the operation, the level of PbrO2 in the study group was significantly higher than that in the control group(P<0.05); after the operation and 1 h after the operation, the levels of malondialdehyde(MDA) and Glutamate (Glu) in the study group were significantly lower than that in the control group (P<0.05), while the level of superoxide dismutase(SOD) in plasma was significantly higher than that in the control group (P<0.05). At T0, there was no significant difference in brain oxygen uptake rate(OER), arterio-venous oxygen content difference(Da-jvO2), cerebral perfusion pressure(CPP) and mean arterial pressure(map) between the two groups(P>0.05). At T1-T3, there were significant differences in OER, Da-jvO2, CPP and MAP between the two groups(P<0.05). Conclusion: Propofol combined with desflurane can be used in the anesthesia of patients with craniocerebral injury, which has stable anesthesia effect, can protect the brain tissue, maintain the balance of brain oxygen supply, ensure the smooth operation and good prognosis. |
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