CAJ | 학술논문

　　目的：观察盐酸戊乙奎醚对神经外科手术患者脑氧供需平衡的影响。方法：选择我院2010～2012年40例脑肿瘤切除术患者，随机分为两组，每组20例。Ⅰ组在麻醉诱导后静脉注射盐酸戊乙奎醚2mg，Ⅱ组加入等量生理盐水。采集诱导后即刻（T1）、切开硬膜即刻（T2）、开硬膜1h后（T3）、2h后（T4）以及关硬膜即刻（T5）桡动脉及颈内静脉血样行血气分析，记录并计算桡动脉-颈内静脉乳酸含量及差值（Laca、Lacjv、Laca-jv）、桡动脉-颈内静脉血氧含量及差值（CaO2、CjvO2、Ca-jvO2）及脑氧摄取率（CERO2）。结果：与T0比较，Ⅰ组在T3、T4、T5时点的Laca-jv值差异无统计学意义（P＞0.05），Ca-jvO2值、CERO2值均低于T1（P＜0.05）；Ⅱ组在T3、T4、T5时点的Laca-jv值增高（P＜0.05），Ca-jvO2值、CERO2值差异无统计学意义（P＞0.05）；与Ⅱ组比较，Ⅰ组在T3、T4、T5时点的Laca-jv值、Ca-jvO2值、CERO2值均降低（P＜0.05）。结论：盐酸戊乙奎醚可在一定程度上改善神经外科手术患者脑氧供需平衡。
　　목적：관찰염산무을규미대신경외과수술환자뇌양공수평형적영향。방법：선택아원2010～2012년40례뇌종류절제술환자，수궤분위량조，매조20례。Ⅰ조재마취유도후정맥주사염산무을규미2mg，Ⅱ조가입등량생리염수。채집유도후즉각（T1）、절개경막즉각（T2）、개경막1h후（T3）、2h후（T4）이급관경막즉각（T5）뇨동맥급경내정맥혈양행혈기분석，기록병계산뇨동맥-경내정맥유산함량급차치（Laca、Lacjv、Laca-jv）、뇨동맥-경내정맥혈양함량급차치（CaO2、CjvO2、Ca-jvO2）급뇌양섭취솔（CERO2）。결과：여T0비교，Ⅰ조재T3、T4、T5시점적Laca-jv치차이무통계학의의（P＞0.05），Ca-jvO2치、CERO2치균저우T1（P＜0.05）；Ⅱ조재T3、T4、T5시점적Laca-jv치증고（P＜0.05），Ca-jvO2치、CERO2치차이무통계학의의（P＞0.05）；여Ⅱ조비교，Ⅰ조재T3、T4、T5시점적Laca-jv치、Ca-jvO2치、CERO2치균강저（P＜0.05）。결론：염산무을규미가재일정정도상개선신경외과수술환자뇌양공수평형。
Objective:To observe the effects of penehyclidine hydrochloride on balance between cerebral oxygen delivery and consumption in patients undergoing surgery of brain tumors. Methods:Forty patients undergoing neurosurgery were equally randomized into two groups. After induction of anesthesia, groupsⅠ received penehyclidine hydrohloride 2mg, groupⅡ received the equal volume of normal saline. Blood samples were taken from radial artery and internal jugular bulb to determine Laca、Lacjv、Laca-jv、CaO2、CjvO2、Ca-jvO2、CERO2,et al,after induction(T1),at the moment of cutting duramater(T2), 1 hafter cutting duramater(T3), 2h after cutting duramater (T4) and closing duramater (T5). Results:Compared with T1, the Ca- jvO2 and CERO2 value at the moment of T3,T4 or T5 decreased significantly in groupⅠ(P<0.05); the Laca- jv value at the moment of T3,T4 or T5 increased sign ificantly in groupⅡ(P<0.05). The Laca-jv、Ca-jvO2、CERO2 values at T3,T4 and T5 in groupⅠwere significantly lower than those in groupⅡ(P<0.05). Conclusion:Penehyclidine hydrochloride has positive effects on maintaining the balance of cerebral oxygen supply-consumption in patients undergoing neurosurgery.