CAJ | 학술논문

目的：研究七氟醚控制性降压用于颅脑手术对围术期血流动力学和脑氧代谢的影响。方法选择择期颅脑手术患者37例,ASA I 或 II 级,在全身麻醉后,随机分为两组,分别给予七氟醚(S 组,n=20)和硝普钠(N 组,n=17)行控制性降压。监测术中 HR、BP、SpO2、ECG,桡动脉、右颈内动脉球部抽血标本行血气分析,计算颈内静脉球部血氧含量差(Da-jvO2)、脑氧代谢率(CMRO2)、心率收缩压乘积(RPP)。结果 S 组在降压达到目标 MAP 时,各时点的 HR 明显慢于 N 组(P <0.05)。两组 Da-jvO2、CMRO2在降压时均下降(P <0.05),但两组差异无统计学意义。S 组 RPP 在降压期间明显低于 N 组(P <0.05)。结论七氟醚控制性降压更能稳定血流动力学状态,同时改善脑氧代谢。
목적：연구칠불미공제성강압용우로뇌수술대위술기혈류동역학화뇌양대사적영향。방법선택택기로뇌수술환자37례,ASA I 혹 II 급,재전신마취후,수궤분위량조,분별급여칠불미(S 조,n=20)화초보납(N 조,n=17)행공제성강압。감측술중 HR、BP、SpO2、ECG,뇨동맥、우경내동맥구부추혈표본행혈기분석,계산경내정맥구부혈양함량차(Da-jvO2)、뇌양대사솔(CMRO2)、심솔수축압승적(RPP)。결과 S 조재강압체도목표 MAP 시,각시점적 HR 명현만우 N 조(P <0.05)。량조 Da-jvO2、CMRO2재강압시균하강(P <0.05),단량조차이무통계학의의。S 조 RPP 재강압기간명현저우 N 조(P <0.05)。결론칠불미공제성강압경능은정혈류동역학상태,동시개선뇌양대사。
Objective To study the effects of controlled hypotension with sevoflurane on hymo-dynamics and cerebral metabolic rate of oxygen in neurosurgery.Methods Thirty-seven ASA Ⅰ or Ⅱpatients undergoing elective intracranial surgery were enrolled.The patients were treated with general anesthesia and assigned to two experimental groups,sevoflurane group (group S,n=20)and sodium nitroprusside group (group N,n=1 7).HR,BP,SpO2 and ECG were continuously monitored during operation.Blood samples were taken from radial artery and internal jugular bulb to determine cerebral arteriovenous oxygen differences (Da-jvO2 ) and cerebral metabolic rate of oxygen (CMRO2 ). Results The HR in group S were decreased during hypotension,5 min,10 min,20 min,and 30 min compared with group N (P <0.05).Da-jvO2 and CMRO2 both in two groups were decreased during hypotension(P < 0.05 ),but there was no difference between the two groups.RPP was lower in group S than in group N during hypotension.Conclusion Controlled hypotension with sevoflurane does not increase HR and improves cerebral blood flow-metabolism coupling.