中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
14期
2119-2121
,共3页
丙泊酚%颅脑损伤%脑%细胞保护
丙泊酚%顱腦損傷%腦%細胞保護
병박분%로뇌손상%뇌%세포보호
Propofol%Craniocerebral trauma%Brain%Cytoprotection
目的 探讨丙泊酚静脉麻醉对急性重型颅脑损伤手术患者的脑保护作用.方法 选择急性重型颅脑损伤手术患者70例,按入院顺序随机分成对照组与观察组,每组35例.观察组静脉给予丙泊酚2 mg/kg进行麻醉诱导,然后以4 mg·kg-1·h-1维持；对照组给予咪达唑仑0.06 mg/kg进行麻醉诱导,然后间断吸入异氟烷维持.两组患者静脉麻醉诱导均加用丙泊酚1.2 mg/kg,芬太尼4μg/kg,维库溴铵0.15 mg/kg.记录麻醉前、术中和术后3h患者颅内压和脑氧分压的变化情况,且记录患者术后初醒时间.结果 两组术后3h与麻醉前比较颅内压明显下降,脑氧分压明显升高；且观察组的颅内压明显低于对照组[(18.98±3.98) mm Hg与 (21.76±4.01) mm Hg](t=7.20,P＜0.05),脑氧分压明显高于对照组[(17.09±3.03) mm Hg与(14.67 ±2.63)mm Hg](t=7.23,P＜0.05),观察组的初醒时间短于对照组[(15.98±2.01)h与(20.01±1.23)h](t=7.96,P＜0.05).结论 丙泊酚静脉麻醉对急性重型颅脑损伤手术患者具有良好的脑保护作用,值得临床推广应用.
目的 探討丙泊酚靜脈痳醉對急性重型顱腦損傷手術患者的腦保護作用.方法 選擇急性重型顱腦損傷手術患者70例,按入院順序隨機分成對照組與觀察組,每組35例.觀察組靜脈給予丙泊酚2 mg/kg進行痳醉誘導,然後以4 mg·kg-1·h-1維持；對照組給予咪達唑崙0.06 mg/kg進行痳醉誘導,然後間斷吸入異氟烷維持.兩組患者靜脈痳醉誘導均加用丙泊酚1.2 mg/kg,芬太尼4μg/kg,維庫溴銨0.15 mg/kg.記錄痳醉前、術中和術後3h患者顱內壓和腦氧分壓的變化情況,且記錄患者術後初醒時間.結果 兩組術後3h與痳醉前比較顱內壓明顯下降,腦氧分壓明顯升高；且觀察組的顱內壓明顯低于對照組[(18.98±3.98) mm Hg與 (21.76±4.01) mm Hg](t=7.20,P＜0.05),腦氧分壓明顯高于對照組[(17.09±3.03) mm Hg與(14.67 ±2.63)mm Hg](t=7.23,P＜0.05),觀察組的初醒時間短于對照組[(15.98±2.01)h與(20.01±1.23)h](t=7.96,P＜0.05).結論 丙泊酚靜脈痳醉對急性重型顱腦損傷手術患者具有良好的腦保護作用,值得臨床推廣應用.
목적 탐토병박분정맥마취대급성중형로뇌손상수술환자적뇌보호작용.방법 선택급성중형로뇌손상수술환자70례,안입원순서수궤분성대조조여관찰조,매조35례.관찰조정맥급여병박분2 mg/kg진행마취유도,연후이4 mg·kg-1·h-1유지；대조조급여미체서륜0.06 mg/kg진행마취유도,연후간단흡입이불완유지.량조환자정맥마취유도균가용병박분1.2 mg/kg,분태니4μg/kg,유고추안0.15 mg/kg.기록마취전、술중화술후3h환자로내압화뇌양분압적변화정황,차기록환자술후초성시간.결과 량조술후3h여마취전비교로내압명현하강,뇌양분압명현승고；차관찰조적로내압명현저우대조조[(18.98±3.98) mm Hg여 (21.76±4.01) mm Hg](t=7.20,P＜0.05),뇌양분압명현고우대조조[(17.09±3.03) mm Hg여(14.67 ±2.63)mm Hg](t=7.23,P＜0.05),관찰조적초성시간단우대조조[(15.98±2.01)h여(20.01±1.23)h](t=7.96,P＜0.05).결론 병박분정맥마취대급성중형로뇌손상수술환자구유량호적뇌보호작용,치득림상추엄응용.
Objective To study the cerebral protective effect of intravenous propofol anaesthesia on the patients with acute severe brain injury.Methods 70 patients with acute severe brain injury were randomly divided into control group and observation group,each group had 35 cases.The observation group was given intravenously propofol 2mg/kg for anesthesia induction,then maintaining anesthetization by 4mg · kg-1 · h-1.The control group was given midazolam,then discontinuous indrawed isoflurane.Diprivan 1.2mg/kg,fentanyl 4μ g/kg and vecuronium bromide 0.15 mg/kg were also used intravenously for the maintenance of anesthesia.The changes of intracranial pressure (IP)and cerebral oxygen partial pressure(COP) before anesthetization,surgery,3 hours after surgery and the waking time of surgery were recorded.Results After treatment,IP of two groups was decreased and COP was increased sharply; the IP of observation group was (18.98 ± 3.98) mm Hg,which was lower than (21.76 ± 4.01)mm Hg of the control group(t =7.20,P ＜ 0.05),COP was (17.09 ± 3.03) mm Hg,which was higher than (14.67 ± 2.63)mm Hg of the control group (t =7.23,P ＜ 0.05).The wake time of observation group was (15.98 ± 2.01) h,which was shorter than (20.01 ± 1.23) h of the control group (t =7.96,P ＜ 0.05).Conclusion The cerebral protective effect of intravenous propofol anaesthesia is good in patients with acute severe brain injury;it is worth to popularize in clinic.
