中华行为医学与脑科学杂志
中華行為醫學與腦科學雜誌
중화행위의학여뇌과학잡지
CHINESE JOURNAL OF BEHAVIORAL MEDICINE AND BRAIN SCIENCE
2011年
1期
35-36
,共2页
颅脑损伤%异丙酚%热休克蛋白70
顱腦損傷%異丙酚%熱休剋蛋白70
로뇌손상%이병분%열휴극단백70
Traumatic brain injury%Propofol%Heat shock protein 70
目的 观察异丙酚和异氟醚麻醉对颅脑损伤患者围术期血清热休克蛋白70(HSP70)水平的影响.方法 选择行开颅血肿清除术治疗的中、重型急性颅脑损伤患者30例,按随机数字表法分为异丙酚组和异氟醚组,每组15例.麻醉诱导后前组患者静脉靶控输注异丙酚(效应室靶浓度为3～4μg/ml),后组患者吸入1.2%异氟醚,并且均间断静注维库溴铵、芬太尼维持麻醉深度.应用ELISA法测定患者麻醉诱导前、打开硬脑膜后1 h、术后24 h血液HSP70的含量,记录患者的术后苏醒时间和气管导管拔除时间.结果 2组患者麻醉诱导前、打开硬脑膜后1 h、术后24 h血液HSP70含量随时间的推移均增加,差异有统计学意义(P＜0.05),与异氟醚组比较,异丙酚组患者在打开硬脑膜后1 h和术后24 h时血液HSP70含量较高[(2.00±0.24)ng/ml,(2.19±0.26)ng/ml,t=2.080,P=0.047;(3.57±0.32)ng/ml,(3.81±0.31)ng/ml,t=2.086,P=0.046],术后苏醒进间和气管导管拔除时间较短[(7.7±2.8)min,(5.6±2.7)min,t=2.091,P=0.046;(8.9±3.9)min,(6.0±3.6)min,t=2.116,P=0.043)],差异有统计学意义,＜0.05).结论 静脉靶控输注异丙酚麻醉可维持颅脑损伤患者围术期适度的应激状态.
目的 觀察異丙酚和異氟醚痳醉對顱腦損傷患者圍術期血清熱休剋蛋白70(HSP70)水平的影響.方法 選擇行開顱血腫清除術治療的中、重型急性顱腦損傷患者30例,按隨機數字錶法分為異丙酚組和異氟醚組,每組15例.痳醉誘導後前組患者靜脈靶控輸註異丙酚(效應室靶濃度為3～4μg/ml),後組患者吸入1.2%異氟醚,併且均間斷靜註維庫溴銨、芬太尼維持痳醉深度.應用ELISA法測定患者痳醉誘導前、打開硬腦膜後1 h、術後24 h血液HSP70的含量,記錄患者的術後囌醒時間和氣管導管拔除時間.結果 2組患者痳醉誘導前、打開硬腦膜後1 h、術後24 h血液HSP70含量隨時間的推移均增加,差異有統計學意義(P＜0.05),與異氟醚組比較,異丙酚組患者在打開硬腦膜後1 h和術後24 h時血液HSP70含量較高[(2.00±0.24)ng/ml,(2.19±0.26)ng/ml,t=2.080,P=0.047;(3.57±0.32)ng/ml,(3.81±0.31)ng/ml,t=2.086,P=0.046],術後囌醒進間和氣管導管拔除時間較短[(7.7±2.8)min,(5.6±2.7)min,t=2.091,P=0.046;(8.9±3.9)min,(6.0±3.6)min,t=2.116,P=0.043)],差異有統計學意義,＜0.05).結論 靜脈靶控輸註異丙酚痳醉可維持顱腦損傷患者圍術期適度的應激狀態.
목적 관찰이병분화이불미마취대로뇌손상환자위술기혈청열휴극단백70(HSP70)수평적영향.방법 선택행개로혈종청제술치료적중、중형급성로뇌손상환자30례,안수궤수자표법분위이병분조화이불미조,매조15례.마취유도후전조환자정맥파공수주이병분(효응실파농도위3～4μg/ml),후조환자흡입1.2%이불미,병차균간단정주유고추안、분태니유지마취심도.응용ELISA법측정환자마취유도전、타개경뇌막후1 h、술후24 h혈액HSP70적함량,기록환자적술후소성시간화기관도관발제시간.결과 2조환자마취유도전、타개경뇌막후1 h、술후24 h혈액HSP70함량수시간적추이균증가,차이유통계학의의(P＜0.05),여이불미조비교,이병분조환자재타개경뇌막후1 h화술후24 h시혈액HSP70함량교고[(2.00±0.24)ng/ml,(2.19±0.26)ng/ml,t=2.080,P=0.047;(3.57±0.32)ng/ml,(3.81±0.31)ng/ml,t=2.086,P=0.046],술후소성진간화기관도관발제시간교단[(7.7±2.8)min,(5.6±2.7)min,t=2.091,P=0.046;(8.9±3.9)min,(6.0±3.6)min,t=2.116,P=0.043)],차이유통계학의의,＜0.05).결론 정맥파공수주이병분마취가유지로뇌손상환자위술기괄도적응격상태.
Objective To investigate the effect of propofol and isoflurane anesthesia on serum heat shock protein 70 ( HSP70 ) of perioperative patients with brain injury and compare the anesthetic effect of the two narcotic drugs. Methods 30 patients with medium or severe traumatic brain injury,treated by hematoma evacuation operation,were randomly divided into propofol ( n = 15 ) and isoflurane group ( n = 15 ). After anesthesia induction,propofol (target effect concentration of 3 ～ 4 μg/ml ) was intravenously injected and 1.2% isoflurane was inhalated into the patients of the 2 groups,respectively. In addition,vecuronium and fentany were intermittent intravenously injected into patients to maintain the depth of anesthesia. HSP70 in blood of patients were detected before anesthesia induction, 1 h after the dura was opened and 24 h after the operation by ELISA method. Recovery and tracheal extubation time of patients were recorded. Results HSP70 levels in blood of patients in the 2 groups were significantly increased compared with the former time point(P＜0.05 ). HSP70 content in propofol group was significantlyhigher at 1 h after the dura was opened( ( 2.00 ± 0. 24 ) ng/ml, ( 2.19 ± 0.26 ) ng/ml, t = 2. 080, P = 0.047 ) and 24 h after the operation( t=2.086, P=0.046) ,and recovery and tracheal extubation time was shorter compared with the isoflurane group(P＜0. 05). Conclusion Perioperative moderate stress,and early postoperative recovery and extubation can be maintained in patients with traumatic brain injury with profol anesthesia.
