CAJ | 학술논문

[目的]观察静脉麻醉下颅内动脉瘤血管栓塞术中血浆内皮素（ET）和降钙素基因相关肽（CGRP）的含量的变化，探讨持续泵入尼莫酮对ET和CGRP的影响。[方法]择期颅内动脉瘤栓塞术患者32例，随机分为两组，尼莫酮组（N组）和对照组（C组），N组持续泵人尼莫酮2 m g/h ，C组术中持续泵入生理盐水10 m L/h直至手术结束。分别于栓塞前后从乙状窦内抽取血液测定 ET 和 CGRP的含量以及监测不同时间段心率和血压。[结果]N组在输注尼莫酮后血压降低在幅度在安全范围内，心率无显著变化，外周血管阻力下降。两组术前ET都显著增高，术后都降低，N组下降幅度大于C组，有统计学意义（ P ＜0．05）。CGRP术前都在正常值范围，术后均增高，两组间比较差异无统计学意义（ P ＞0．05）。[结论]在颅内动脉瘤栓塞术中，瑞芬复合丙泊酚可以缓解脑血管痉挛，而持续泵入尼莫酮2 mg/h ，对改善脑血管痉挛作用不显著。
[목적]관찰정맥마취하로내동맥류혈관전새술중혈장내피소（ET）화강개소기인상관태（CGRP）적함량적변화，탐토지속빙입니막동대ET화CGRP적영향。[방법]택기로내동맥류전새술환자32례，수궤분위량조，니막동조（N조）화대조조（C조），N조지속빙인니막동2 m g/h ，C조술중지속빙입생리염수10 m L/h직지수술결속。분별우전새전후종을상두내추취혈액측정 ET 화 CGRP적함량이급감측불동시간단심솔화혈압。[결과]N조재수주니막동후혈압강저재폭도재안전범위내，심솔무현저변화，외주혈관조력하강。량조술전ET도현저증고，술후도강저，N조하강폭도대우C조，유통계학의의（ P ＜0．05）。CGRP술전도재정상치범위，술후균증고，량조간비교차이무통계학의의（ P ＞0．05）。[결론]재로내동맥류전새술중，서분복합병박분가이완해뇌혈관경련，이지속빙입니막동2 mg/h ，대개선뇌혈관경련작용불현저。
[Objective] To observe the changes in the levels of plasma endothelin(ET ) and calcitonin gene-re-lated peptide(CGRP) during intracranial aneurysm embolization under intravenous anesthesia ,and to explore the effect of continuous infusion with nimotong on ET and CGRP .[Methods]A total of 32 patients undergoing selec-tive embolization of intracranial aneurysms were randomly divided into nimotong group (group N ) and control group(group C) .Group N was given continuous infusion with nimotong 2mg/h ,while group C was given continu-ous infusion of normal saline 10ml/h until the end of surgery .Blood samples were taken from sigmoid sinus to de-tect the level of ET and CGRP before and after embolization .Heart rate and blood pressure were monitored at dif-ferent time .[Results] After injection with nimotong ,blood pressure of group N decreased in a safe range ,and heart rate had no significant change ,and peripheral vascular resistance reduced .The level of two groups increased significantly before treatment and decreased after treatment ,but the decreasing of group N was more than that of group C ,and there was significant difference( P <0 .05) .The level of CGRP in two groups was in the normal range before the operation and increased after the operation ,but there was no significant difference between two groups( P>0 .05) .[Conclusion]In the embolization of intracranial aneurysm ,remifentanil combined with propofol can alleviate cerebral vasospasm .Continuous pumping with nimotong 2mg/h has no significant effect to improve cerebral vasospasm .