本文選題：丙泊酚 + 麻醉　； 參考：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年26期

【摘要】：目的探討不同丙泊酚靶控麻醉維持劑量對(duì)非體外循環(huán)下冠狀動(dòng)脈旁路移植術(shù)(op-CABG)患者術(shù)后認(rèn)知功能障礙(POCD)及神經(jīng)生長(zhǎng)因子(NGF)表達(dá)水平的影響。方法選取2013年5月-2015年4月在該院實(shí)施co-CABG術(shù)的105例患者,按照數(shù)字表法分成3組,根據(jù)丙泊酚靶控麻醉劑量的不同分為高劑量組(丙泊酚3.0μg/ml)、中劑量組(丙泊酚2.5~3.0μg/ml)、低劑量組(丙泊酚2.5μg/ml),每組35例,比較3組患者在手術(shù)時(shí)間、麻醉時(shí)間、POCD發(fā)生率的差異,并對(duì)麻醉各時(shí)期3組麻醉深度、血流動(dòng)力學(xué)指標(biāo)及NGF表達(dá)水平進(jìn)行比較。結(jié)果 3組患者在手術(shù)時(shí)間、麻醉時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),但中、高劑量組POCD發(fā)生率分別為11.4%和5.7%,均低于低劑量組的31.4%(P0.05);中、高劑量組麻醉深度、平均動(dòng)脈壓比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),但兩者數(shù)值低于低劑量組(P0.05);而3組圍手術(shù)期中心率變化比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);手術(shù)結(jié)束后,中、高劑量組患者NGF表達(dá)水平也高于低劑量組(P0.05)。結(jié)論 2.5~3.0μg/ml丙泊酚靶控劑量維持麻醉可在獲得滿意麻醉深度的同時(shí),減少藥物對(duì)機(jī)體血流動(dòng)力學(xué)的影響,并有利于降低POCD的發(fā)生,促進(jìn)NGF的表達(dá)。
[Abstract]:Objective to investigate the effects of different maintenance doses of propofol target-controlled anesthesia on the expression of POCDand NGF in patients with cognitive dysfunction and NGF after off-pump coronary artery bypass grafting (CABG). Methods 105 patients undergoing co-CABG from May 2013 to April 2015 were divided into 3 groups according to digital table method. According to the different dose of propofol target controlled anesthesia, the patients were divided into high dose group (propofol 3.0 渭 g / ml), middle dose group (2.5 渭 g / ml propofol 2.5 渭 g / ml) and low dose group (2.5 渭 g / ml propofol, 35 cases in each group). The anesthetic depth, hemodynamic index and NGF expression were compared among the three groups. Results there was no significant difference in the operation time and anesthesia time among the three groups, but the incidence of POCD in the middle and high dose groups was 11.4% and 5.7, respectively, which was lower than that in the low dose group (31.4%, P 0.05), and the anesthetic depth in the middle and high dose group was lower than that in the high dose group. There was no significant difference in mean arterial pressure between the two groups, but the mean arterial pressure was lower than that in the low dose group (P 0.05), but there was no significant difference between the three groups in the central rate during the perioperative period (P 0.05). The expression of NGF in high dose group was higher than that in low dose group (P 0.05). Conclusion maintenance of target controlled dose of 2.5 渭 g/ml propofol can not only obtain satisfactory anesthetic depth, but also reduce the effect of drug on hemodynamics, decrease the occurrence of POCD and promote the expression of NGF.
【作者單位】： 河北大學(xué)附屬醫(yī)院麻醉科;河北省望都縣人民醫(yī)院麻醉科;河北省定州市人民醫(yī)院麻醉科;
【分類號(hào)】：R614

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